{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T02:57:06Z","timestamp":1790477826157,"version":"4.1.0"},"reference-count":47,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2011,4,11]],"date-time":"2011-04-11T00:00:00Z","timestamp":1302480000000},"content-version":"unspecified","delay-in-days":861,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2008,12]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>This paper discusses some key aspects of the debate on the difficulties of incorporating scientific evidence into the daily work of clinicians in mental health services (MHS). It highlights the topics of: the utility of guidelines in this field, the ethical principles that should guide their utilisation, their limitations, obstacles impeding the diffusion of guidelines in psychiatry, and strategies that can be useful for overcoming the barriers to guideline implementation. The SIEP-DIRECT's ((<jats:italic>DIscrepancy between Routine practice and Evidence in psychiatric Community Treatments on Schizophrenia<\/jats:italic>) Project's potential role in fostering this advancement is discussed in detail. This Project developed a set of 103 indicators that operationalised the NICE clinical guidelines for schizophrenia recommendations and tested them in 19 MHS in Italy. A multi-step design was used to assess recommendation and indicator acceptability in the Italian context; provide an assessment of any current discrepancies between routine practice and guideline recommendations in the treatment of schizophrenia; and understand the reasons for any discrepancies that might emerge. This process, moreover, was instrumental in keeping the debate arising during conduction of this Project far from the excesses of hostility - and excesses of \u201cbright-eyed enthusiasm\u201d - that frequently influence discussion on topic. This Project therefore showed potential to serve in the search for a happy medium, that can facilitate the pursuit of a fundamental advancement in guideline implementation in mental health services.<\/jats:p><jats:p><jats:bold>Declaration of Interest<\/jats:bold>: None.<\/jats:p>","DOI":"10.1017\/s1121189x00000087","type":"journal-article","created":{"date-parts":[[2015,10,28]],"date-time":"2015-10-28T04:34:56Z","timestamp":1446006896000},"page":"270-277","source":"Crossref","is-referenced-by-count":22,"title":["Guidelines for treating mental illness: love them, hate them. Can the SIEP-DIRECT's Project serve in the search for a happy medium?"],"prefix":"10.1017","volume":"17","author":[{"given":"Mirella","family":"Ruggeri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2011,4,11]]},"reference":[{"key":"S1121189X00000087_ref020","first-page":"180","article-title":"Deconstructing the evidence-based discourse in health sciences: truth, power and fascism","volume":"4","author":"Holmes","year":"2006","journal-title":"International Journal of Evidence Based Mental Health Care"},{"key":"S1121189X00000087_ref045","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp0706425"},{"key":"S1121189X00000087_ref046","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2007.01016.x"},{"key":"S1121189X00000087_ref041","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1017\/S1121189X00000099","article-title":"The SIEP-DIRECT's Project on the discrepancy between routine practice and evidence in the treatment of schizophrenia. The design, the indicators, and the methodology of the study (in Italian)","volume":"17","author":"Semisa","year":"2008","journal-title":"Epidemiologia e Psichiatria Sociale"},{"key":"S1121189X00000087_ref035","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2007.01093.x"},{"key":"S1121189X00000087_ref042","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2850.2007.01202.x"},{"key":"S1121189X00000087_ref029","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1017\/S1121189X00000063","article-title":"Advantages and limitations of clinical guidelines: can we change clinicians' behaviour?","volume":"17","author":"Mele","year":"2008","journal-title":"Epidemiologia e Psichiatria Sociale"},{"key":"S1121189X00000087_ref032","doi-asserted-by":"publisher","DOI":"10.1192\/apt.10.6.403"},{"key":"S1121189X00000087_ref026","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.54.3.370"},{"key":"S1121189X00000087_ref017","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200108002-00003"},{"key":"S1121189X00000087_ref015","doi-asserted-by":"publisher","DOI":"10.1080\/j.1440-1614.2004.01450.x"},{"key":"S1121189X00000087_ref014","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.187.3.248"},{"key":"S1121189X00000087_ref009","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291705005933"},{"key":"S1121189X00000087_ref016","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14546-1"},{"key":"S1121189X00000087_ref005","doi-asserted-by":"publisher","DOI":"10.1017\/S1121189X00002761"},{"key":"S1121189X00000087_ref001","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1017\/S1121189X0000004X","article-title":"NICE guidelines and the role of indicators","volume":"17","author":"Baillie","year":"2008","journal-title":"Epidemiologia e Psichiatria Sociale"},{"key":"S1121189X00000087_ref021","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1017\/S1121189X00002785","article-title":"So what shall we do about assertive community treatment?","volume":"17","author":"Johnson","year":"2008","journal-title":"Epidemiologia e Psichiatria Sociale"},{"key":"S1121189X00000087_ref012","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-8-64"},{"key":"S1121189X00000087_ref004","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2004.00763.x"},{"key":"S1121189X00000087_ref043","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511544347"},{"key":"S1121189X00000087_ref007","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1017\/S1121189X00000051","article-title":"And how shall we deal with adaptation and implementation of NICE schizophrenia guidelines in Italy? Much more than just cutting a good figure","volume":"17","author":"Carr\u00e0","year":"2008","journal-title":"Epidemiologia e Psichiatria Sociale"},{"key":"S1121189X00000087_ref034","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1017\/S1121189X0000275X","article-title":"Case management or assertive community treatment: are they really alternative approaches?","volume":"17","author":"Ruggeri","year":"2008","journal-title":"Epidemiologia e Psichiatria Sociale"},{"key":"S1121189X00000087_ref022","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.51.3.336"},{"key":"S1121189X00000087_ref013","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-0953"},{"key":"S1121189X00000087_ref030","volume-title":"Schizophrenia: Full National Clinical Guideline on Core Interventions in Primary and Secondary Care.","year":"2003"},{"key":"S1121189X00000087_ref025","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2007.01030.x"},{"key":"S1121189X00000087_ref002","first-page":"773","article-title":"The development of a survey instrument for community health improvement","volume":"36","author":"Bazos","year":"2001","journal-title":"Health Services Research"},{"key":"S1121189X00000087_ref008","doi-asserted-by":"publisher","DOI":"10.1017\/S0007125000161793"},{"key":"S1121189X00000087_ref018","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1097\/01.MLR.0000062920.51692.B4","article-title":"Measuring the quality of depression care in a large integrated health system","volume":"41","author":"Hankin","year":"2003","journal-title":"Medical Care"},{"key":"S1121189X00000087_ref003","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2008.59.7.782"},{"key":"S1121189X00000087_ref033","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.184.1.48"},{"key":"S1121189X00000087_ref031","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2007.58.8.1119"},{"key":"S1121189X00000087_ref024","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-176X(199812)1:4<199::AID-MHP22>3.0.CO;2-Z"},{"key":"S1121189X00000087_ref038","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1017\/S1121189X00000075","article-title":"Use of clinical and service indicators to decrease the treatment gap for mental disorders: a global perspective","volume":"17","author":"Saxena","year":"2008","journal-title":"Epidemiologia e Psichiatria Sociale"},{"key":"S1121189X00000087_ref027","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2007.58.10.1279"},{"key":"S1121189X00000087_ref040","doi-asserted-by":"publisher","DOI":"10.1176\/ps.2007.58.6.816"},{"key":"S1121189X00000087_ref036","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1017\/S1121189X00000154","article-title":"The SIEP-DIRECT's Project on the discrepancy between routine practice and evidence. An outline of the main findings and the practical implications for the future of community based mental health services","volume":"17","author":"Ruggeri","year":"2008","journal-title":"Epidemiologia e Psichiatria Sociale"},{"key":"S1121189X00000087_ref037","doi-asserted-by":"publisher","DOI":"10.1136\/jme.2003.003145"},{"key":"S1121189X00000087_ref047","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n0815"},{"key":"S1121189X00000087_ref044","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.52.1.45"},{"key":"S1121189X00000087_ref028","first-page":"186","article-title":"Usefulness and limitations of treatment guidelines in psychiatry","volume":"1","author":"McIntyre","year":"2002","journal-title":"World Psychiatry"},{"key":"S1121189X00000087_ref010","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.52.2.179"},{"key":"S1121189X00000087_ref019","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.53.3.281"},{"key":"S1121189X00000087_ref011","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/41.3.312"},{"key":"S1121189X00000087_ref006","volume-title":"Schizofrenia. Linee Guida Cliniche Complete per gli Interventi Fondamentali nella Medicina di Base e Specialistica.","author":"Carr\u00e0","year":"2004"},{"key":"S1121189X00000087_ref039","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-006-0053-3"},{"key":"S1121189X00000087_ref023","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2007.01089.x"}],"container-title":["Epidemiology and Psychiatric Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1121189X00000087","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T21:51:20Z","timestamp":1567288280000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1121189X00000087\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,12]]},"references-count":47,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2008,12]]}},"alternative-id":["S1121189X00000087"],"URL":"https:\/\/doi.org\/10.1017\/s1121189x00000087","relation":{},"ISSN":["2045-7960","2045-7979"],"issn-type":[{"value":"2045-7960","type":"print"},{"value":"2045-7979","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,12]]}}}