Evidence map›Paper›PMID 39882596›Full record

ArticleEuropean psychiatry : the journal of the Association of European Psychiatrists2025

Developing the EPA guidance of pharmacological treatment of schizophrenia - results of a Delphi process.

Peter Falkai, Elias Wagner, Miriam John, Vladislav Yakimov, Silvana Galderisi, Istvan Bitter, Geert Dom, Andrea Schmitt, Wolfgang Gaebel, Bernardo Carpiniello and 1 more

Abstract read
In one paragraph

Article in European psychiatry : the journal of the Association of European Psychiatrists, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. The Australian and New Zealand journal of psychiatry · 2026
    Guideline
  2. The new German evidence- and consensus-based schizophrenia guideline.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026
    Article
  3. Schizophrenia treatment preferences of psychiatrists versus guidelines: A European perspective.European psychiatry : the journal of the Association of European Psychiatrists · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Peter FalkaiDepartment of Psychiatry and Psychotherapy, LMU University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
Elias WagnerDepartment of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, University of Augsburg, Augsburg, Germany.ORCID 0000-0002-7147-6167
Miriam JohnDepartment of Psychiatry and Psychotherapy, LMU University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
Vladislav YakimovDepartment of Psychiatry and Psychotherapy, LMU University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.ORCID 0000-0001-9559-7492
Silvana GalderisiDepartment of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.ORCID 0000-0002-1592-7656
Istvan BitterDepartment of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.ORCID 0000-0002-9464-4709
Geert DomCollaborative Antwerp Psychiatric Research Institute, Wilrijk, Belgium.ORCID 0000-0001-6492-0429
Andrea SchmittDepartment of Psychiatry and Psychotherapy, LMU University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.ORCID 0000-0002-5426-4023
Wolfgang GaebelDepartment of Psychiatry and Psychotherapy, Heinrich Heine University, Düsseldorf, Germany.
Bernardo CarpinielloSection of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Alkomiet HasanDepartment of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, University of Augsburg, Augsburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe development of guidelines is time-consuming and cost-intensive. The heterogeneity of clinical practice, evidence, and patients' needs is an issue across Europe. An European core guidance for a specific psychiatric disorder may help to overcome this issue. Here, we present a progress report on the European Psychiatric Association (EPA) proof-of-concept approach to develop a European consensus guidance on the pharmacological treatment of schizophrenia.

methodsAll national psychiatric associations in Europe were contacted to provide their schizophrenia guidelines. Six guidelines were rated by three experts, experienced in the development of national and international guidelines, from three different countries (Italy, Hungary, and Germany), and the German schizophrenia guideline published in 2019 was found to have the highest quality. For this proof-of-concept approach, 45 recommendations on the pharmacological treatment of schizophrenia from the German guideline were evaluated in a two-step Delphi process to determine their acceptability throughout the European continent.

results44 experts participated in the first round and 40 experts in the second round of the Delphi process. Agreement among the involved experts was reached for 75% of the presented recommendations from the German schizophrenia guidelines. 11 out of 45 recommendations (24.4%) did not reach this level of agreement.

conclusionsThis progress report highlights the possibility of developing a pan-European core guidance on the pharmacological treatment of schizophrenia by adapting national guidelines and reconciling their recommendations. However, several barriers in this adaptation process, such as non-agreement in recommendations with strong scientific evidence in the reconciling process, were identified and must be considered when developing the final guidance.

Indexed as

Antipsychotic AgentsConsensusPractice Guidelines as TopicPsychiatrySchizophreniaDelphi TechniqueEuropeHumansSocieties, MedicalAntipsychotic AgentsAntipsychoticsEuropeGuidelineSchizophreniaTreatment

Identifiers

PMID39882596
PMCPMC11883772

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.