The French Consensus Conference on long-term therapeutic strategies for schizophrenic psychoses

Conclusion

These guidelines have been sent personally to every psychiatrist and to all members of UNAFAM, in all, to more than 20 000 persons; they have been widely covered by medical and non-medical professional journals, as well as by ordinary journals. A book has been published containing the papers produced by experts and their bibliography.

While the content of these guidelines may seem unremarkable in an international context, the fact that they have been produced on a consensus basis and that they have been widely accepted by psychiatrists previously noted for their divisions was a major event for French psychiatry. Of course, the theme was chosen because it was thought that a consensus was feasible and the questions were selected in order to pursue that goal.

The consensus method has its own flaws; it is applied to subjects where consensus is feasible and will exclude subjects that are too controversial. In addition, it is based on an “objective” analysis of the existing research; for topics like psychotherapy (especially psychoanalytic psychotherapy) and even some techniques for reintegration, such research does not exist and the experts' advice has to be based on a more subjective basis than for other topics.

Guidelines concerning psychotropic drugs can be drawn from scientific research and it was thought that the Conference guidelines would be extremely helpful to psychiatrists, although it remains to be seen how much they will influence practice. There are, in fact, plans to compare the use of drugs in different settings before and after the publication of the guidelines.

Finally, the Consensus Conference was the first tentative attempt to produce guidelines in psychiatry on a wide scale and will be used to encourage a quality control process that previously has not existed in France.