TY - JOUR
T1 - Real-world comprehensive care of people living with schizophrenia
T2 - recommendations across different settings and clinical stages
AU - Fusar-Poli, Paolo
AU - Pillinger, Toby
AU - McCutcheon, Robert A.
AU - Rangaswamy, Thara
AU - Asmal, Laila
AU - Singh, Swaran P.
AU - Oliver, Dominic
AU - Stefanelli, Riccardo
AU - Crossley, Nicolas A.
AU - Gadelha, Ary
AU - Lopez-Jaramillo, Carlos
AU - Mutamba, Byamah B.
AU - Cheour, Majda
AU - Valencia, Marcelo
AU - Asher, Laura
AU - Aymerich, Claudia
AU - Catalan, Ana
AU - Yon, Dong Keon
AU - Shin, Jae Il
AU - Solmi, Marco
AU - Lawrie, Stephen M.
AU - Kulisewa, Kazione
AU - Karpenko, Olga
AU - Ben-Zeev, Dror
AU - Cortese, Samuele
AU - Lund, Crick
AU - Howes, Oliver
AU - Kéri, Peter
AU - Sunkel, Charlene
AU - Bonoldi, Ilaria
AU - Damiani, Stefano
AU - Fusar-Poli, Laura
AU - McGorry, Patrick D.
AU - Kane, John M.
AU - Correll, Christoph U.
N1 - Publisher Copyright:
© 2026 World Psychiatric Association.
PY - 2026/6
Y1 - 2026/6
N2 - The clinical management of a complex disorder such as schizophrenia remains a significant challenge worldwide. This disorder requires a comprehensive, integrated and personalized care that blends multiple approaches, and the real-world availability of multiple resources. We present here the first recommendations addressing the real-world comprehensive care for people with schizophrenia-spectrum psychoses across different approaches, clinical stages, and levels of available resources. The recommendations are based on a critical review of the scientific literature and a collaborative appraisal by numerous clinical academics actively treating people with schizophrenia worldwide, representing various countries and clinical settings, including those in the Global South. Experts by experience were also involved. Our recommendations indicate that the comprehensive care of schizophrenia should involve: a) early detection; b) measurement-based monitoring; c) pharmacological treatments; d) psychological interventions; e) psychosocial interventions (including supported employment, housing and education); f) management of somatic conditions; g) community care; h) inpatient care; i) peer support, self-help, and alternative healing methods; j) population-level prevention, and l) societal-level support. The overarching core recommendation is to implement evidence-based care that addresses disparities across high- to middle/low-resource settings, emphasizing early intervention (and prevention when possible), culturally-sensitive paradigms that leverage the local existing resources, and task-sharing models that involve non-professional health care workers and, if possible, traditional healers. In the future, we expect that scalable and resource-saving, evidence-based digital solutions will help extend and improve care quality and efficiency across all resource settings. However, none of this can be achieved without adequately focusing on and strengthening mental health funding, improving access to care, addressing social determinants of health, and recognizing that care for people at risk for or living with schizophrenia is uneven and in need of improvement across all settings.
AB - The clinical management of a complex disorder such as schizophrenia remains a significant challenge worldwide. This disorder requires a comprehensive, integrated and personalized care that blends multiple approaches, and the real-world availability of multiple resources. We present here the first recommendations addressing the real-world comprehensive care for people with schizophrenia-spectrum psychoses across different approaches, clinical stages, and levels of available resources. The recommendations are based on a critical review of the scientific literature and a collaborative appraisal by numerous clinical academics actively treating people with schizophrenia worldwide, representing various countries and clinical settings, including those in the Global South. Experts by experience were also involved. Our recommendations indicate that the comprehensive care of schizophrenia should involve: a) early detection; b) measurement-based monitoring; c) pharmacological treatments; d) psychological interventions; e) psychosocial interventions (including supported employment, housing and education); f) management of somatic conditions; g) community care; h) inpatient care; i) peer support, self-help, and alternative healing methods; j) population-level prevention, and l) societal-level support. The overarching core recommendation is to implement evidence-based care that addresses disparities across high- to middle/low-resource settings, emphasizing early intervention (and prevention when possible), culturally-sensitive paradigms that leverage the local existing resources, and task-sharing models that involve non-professional health care workers and, if possible, traditional healers. In the future, we expect that scalable and resource-saving, evidence-based digital solutions will help extend and improve care quality and efficiency across all resource settings. However, none of this can be achieved without adequately focusing on and strengthening mental health funding, improving access to care, addressing social determinants of health, and recognizing that care for people at risk for or living with schizophrenia is uneven and in need of improvement across all settings.
KW - community care
KW - early intervention
KW - measurement-based monitoring
KW - middle/low-resource settings
KW - pharmacotherapy
KW - population-level prevention
KW - psychosocial interventions
KW - real-world comprehensive care
KW - Schizophrenia
KW - societal-level support
UR - https://www.scopus.com/pages/publications/105039164279
U2 - 10.1002/wps.70066
DO - 10.1002/wps.70066
M3 - Article
AN - SCOPUS:105039164279
SN - 1723-8617
VL - 25
SP - 231
EP - 264
JO - World Psychiatry
JF - World Psychiatry
IS - 2
ER -