Schizophrenia treatment preferences of psychiatrists versus guidelines: A European perspective

作者：Martina Rojnić Kuzman, Merete Nordentoft, Andrea Raballo, Pavel Mohr, Andrea Fiorillo, Geert Dom, Goran Mihajlović, Tihana Jendričko, Егор Чумаков, Stojan Barjaktarov, Bernardo Carpiniello, Michal Patarák, Lorcan Martin, Dominika Dudek, Jerzy Samochowiec, Māris Taube, Philippe Courtet, Dragan Babić, G. Račetović, Kirsten Catthoor, Celso Arango, N. Maruta, Koray Başar, Simavi Vahip, György Szekeres, Lars Lien, Ana Popova, Ruslan Zhelev, Erika Jääskeläinen, M. Delić, Eka Chkonia, Jana Chihai, Diogo Telles‐Correia, Doina Cosman, Julian Beezhold, Peter Falkai · 发表于：European Psychiatry · 年份：2025 · DOI：10.1192/j.eurpsy.2025.10072 · 被引用次数：6 · 研究领域：Schizophrenia research and treatment、Healthcare Decision-Making and Restraints、Clinical practice guidelines implementation

BACKGROUND: We aimed to identify therapeutic approaches for managing schizophrenia in different phases and clinical situations - the prodromal phase, first-episode psychosis, cognitive and negative symptoms, pregnancy, treatment resistance, and antipsychotic-induced metabolic side effects - while assessing clinicians' adherence to guidelines. METHODS: A cross-sectional online survey was conducted in 2023 as part of the Ambassador project among psychiatrists and trainees from 35 European countries, based on a questionnaire that included six clinical vignettes (cases A-F). Additionally, a review of multiple guidelines/guidance papers was performed. RESULTS: The final analysis included 454 participants. Our findings revealed a moderate to high level of agreement among European psychiatrists regarding pharmacological treatment preferences for first-episode psychosis and cognitive and negative symptoms, prodromal symptoms and pregnancy, with moderate adherence to clinical guidelines. There was substantial similarity in treatment preferences for antipsychotic-induced metabolic side effects and treatment resistance; however, adherence to guidelines in these areas was only partial. Despite guideline recommendations, non-pharmacological treatments, including psychotherapy and recovery-oriented care, were generally underutilized, except for psychoeducation and lifestyle recommendations, and cognitive behavioural therapy for treatment of the prodromal phase. Contrary to guidelines, cogn...