Guidance
This guideline covers recognising and managing psychosis and schizophrenia in adults. It aims to improve care through early recognition and treatment, and by focusing on long-term recovery. It also recommends checking for coexisting health problems and providing support for family members and carers.
Last reviewed: 19 September 2024
We added links to relevant technology appraisal guidance in the sections on assessment and care planning and interventions for people whose illness has not responded adequately to treatment. This is to provide easy access to relevant guidance at the right point in the guideline only and is not a change in practice.
In July 2024, we simplified the guideline by removing recommendations on general principles of care that are covered in other NICE guidelines (for example, the NICE guideline on service user experience in adult mental health). This is a presentational change only, and no changes to practice are intended.
This guideline updates and replaces NICE guideline CG82 (March 2009) and evidence summary ESNM39 (March 2014).
Next review: We have reviewed our guidelines portfolio to identify topics that we think will add the most value to the health and care system and have agreed the update recommended in the 2023 exceptional surveillance report will not proceed as planned. We will continue to monitor this topic for new evidence.
Recommendations
This guideline includes recommendations on:
- recognising and preventing psychosis
- early intervention for a first episode of psychosis
- treating and referring people with an acute episode of psychosis or schizophrenia
- promoting recovery and long-term care
- preventing and treating physical health problems and continuing to check for physical health problems
- support for carers
Who is it for?
- Healthcare professionals
- People with psychosis or schizophrenia, their families and carers
Guideline development process
How we develop NICE guidelines
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.