Background and Hypothesis The World Health Organization’s (WHOs) Mental Health Gap Action Programme (mhGAP) aims to improve healthcare for mental, neurological, and substance use disorders in nonspecialized settings, with a focus on low- and middle-income countries (LMICs). mhGAP includes guidelines for the treatment of psychoses (including schizophrenia), which were recently updated in 2023. The complexity of the WHO guideline update process and the updated recommendations on psychoses are presented. Study Design The WHO guideline development process is outlined as well as the evidence appraisal and the translation of the evidence into recommendations following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. The guideline update process includes a review of the literature, a compilation of systematic reviews, and extracting data related to critical and important outcomes. The updated recommendations and the justifying evidence are discussed. Study Results The WHO mhGAP guidelines for psychoses are adapted to LMICs, and consist of 13 recommendations in 2023, whereof 5 were updated, and 1 recommendation was newly developed. Background information on how these recommendations were obtained, and significant changes since the previous guideline update in 2015 are provided. Conclusions Unlike other guidelines, the WHO must consider various countries, contextual factors, and the WHO Model Lists of Essential Medicines when developing its guidelines. A transformation of the WHO guideline for psychoses into a living guideline would ensure always up-to-date recommendations and facilitate shared decision-making.

中文翻译：

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世界卫生组织精神病（包括精神分裂症）心理健康差距行动计划指南的更新

背景和假设世界卫生组织 (WHO) 的心理健康差距行动计划 (mhGAP) 旨在改善非专业环境中精神、神经和物质使用障碍的医疗保健，重点关注低收入和中等收入国家 (LMIC)。 mhGAP 包括最近于 2023 年更新的精神病（包括精神分裂症）治疗指南。介绍了 WHO 指南更新过程的复杂性以及关于精神病的更新建议。研究设计 概述了世界卫生组织指南的制定过程以及证据评估以及按照建议分级、评估、制定和评价 (GRADE) 方法将证据转化为建议。指南更新过程包括文献综述、系统评价汇编以及提取与关键和重要结果相关的数据。讨论了更新的建议和合理的证据。研究结果 WHO mhGAP 精神病指南适应了中低收入国家，2023 年包含 13 项建议，其中更新了 5 项，新制定了 1 项建议。提供了有关如何获得这些建议的背景信息，以及自 2015 年上次指南更新以来的重大变化。结论 与其他指南不同，世界卫生组织在制定指南时必须考虑不同国家、背景因素和世界卫生组织基本药物标准清单。将世界卫生组织精神病指南转变为现行指南将确保始终提供最新的建议并促进共同决策。