Psychiatry Clinical Practice Guidelines (CPGs)

Primer

Clinical Practice Guidelines (CPGs) (“Evidence-based guidelines”) are systematically developed statements to assist clinicians and patient in making decisions about appropriate health care for specific clinical circumstances. Often times, CPGs have an algorithmic or flow chart approach to help clinicians make decisions. Many different CPGs exists in different jurisdictions and countries. Here is a brief overview of the most common guidelines used in psychiatry around the world, with a focus on Canadian, American, British, Australian, and international guidelines. It is important to note that clinical guidelines are just that, guidelines, and can be subject to biases and conflicts of interest.

Major Depressive Disorder

Depression

Depression Guidelines

Guideline Location Year PDF Website
Canadian Network for Mood and Anxiety Treatments (CANMAT) Canada 2016 PDF Link
American Psychiatric Association (APA) USA 2010 PDF • Guideline (2010)
• Quick Reference
National Institute for Health and Care Excellence (NICE) UK 2019 • PDF (adults)
• PDF (children and youth) 		• Link (adults)
• Link (children and youth)
The Royal Australian and New Zealand College of Psychiatrists (RANZCP) AUS, NZ 2020 PDF Link
American Academy of Pediatrics (AAP) Guidelines for Adolescent Depression in Primary Care (GLAD-PC) USA 2018 PDF Link

Perimenopause

Perimenopausal Depression Guidelines

Guideline Location Year PDF Website
Canadian Network for Mood and Anxiety Treatments (CANMAT) Canada 2016 - Link
North American Menopause Society (NAMS) and the Women and Mood Disorders Task Force of the National Network of Depression Centers USA 2018 - Link

Bipolar

Bipolar Disorder Guidelines

Guideline Location Year PDF Website
Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) Canada, International 2018 PDF Link
American Psychiatric Association (APA) USA 2002 PDF • Guideline (2002)
• Guideline Watch (2005)
• Quick Reference
National Institute for Health and Care Excellence (NICE) UK 2014 PDF Link
British Association for Psychopharmacology (BAP) UK 2016 PDF Link
Royal Australian and New Zealand College of Psychiatrists (RANZCP) AUS, NZ 2020 PDF Link

Schizophrenia

Schizophrenia Guidelines

Guideline Location Year PDF Website
Canadian Schizophrenia Guidelines Canada 2017 - Link
National Institute for Health and Care Excellence (NICE) UK 2014 - Link
Scottish Intercollegiate Guidelines Network (SIGN) UK 2013 - Link
American Psychiatric Association (APA) USA 2021 - Link
Royal Australian and New Zealand College of Psychiatrists (RANZCP) AUS, NZ 2016 - Link

Anxiety Disorders

Generalized Anxiety Disorder

Generalized Anxiety Disorder Guidelines

Guideline Location Year PDF Website
Canadian Clinical Practice Guidelines for the Management of Anxiety, Posttraumatic Stress and Obsessive-Compulsive Disorders Canada 2014 - Link
Canadian Network for Mood and Anxiety Treatments (CANMAT) Canada 2012 - Link
National Institute for Health and Care Excellence (NICE) UK 2011, 2019 - Link
Royal Australian and New Zealand
College of Psychiatrists (RANZCP) 		AUS, NZ 2018 - Link

Specific Phobia

Specific Phobia Guidelines

Guideline Location Year PDF Website
Canadian Clinical Practice Guidelines for the Management of Anxiety, Posttraumatic Stress and Obsessive-Compulsive Disorders Canada 2014 - Link

Panic Disorder

Panic Disorder Guidelines

Guideline Location Year PDF Website
Canadian Clinical Practice Guidelines for the Management of Anxiety, Posttraumatic Stress and Obsessive-Compulsive Disorders Canada 2014 - Link
National Institute for Health and Care Excellence (NICE) UK 2011, 2019 - Link
American Psychiatric Association (APA) USA 2009 - • Guideline (2009)
• Quick Reference Guide
Royal Australian and New Zealand
College of Psychiatrists (RANZCP) 		AUS, NZ 2018 - Link

Social Anxiety Disorder

Social Anxiety Disorder Guidelines

Guideline Location Year PDF Website
Canadian Clinical Practice Guidelines for the Management of Anxiety, Posttraumatic Stress and Obsessive-Compulsive Disorders Canada 2014 - Link
National Institute for Health and Care Excellence (NICE) UK 2013 - Link
Royal Australian and New Zealand
College of Psychiatrists (RANZCP) 		AUS, NZ 2018 - Link

Obsessive-Compulsive Disorders

OCD

OCD Guidelines

Guideline Location Year PDF Website
Canadian Clinical Practice Guidelines Canada 2014 - Link
National Institute for Health and Care Excellence (NICE) UK 2005 - Link
American Psychiatric Association (APA) USA 2007, 2013 - • Guideline (2007)
• Guideline Watch (2013)
• Quick Reference

Trichotillomania

Trichotillomania Guidelines

Guideline Location Year PDF Website
American Psychiatric Association (APA) USA 2016 - Link

Acute and Post-Traumatic Stress Disorder (PTSD)

Acute and Post-Traumatic Stress Disorder Guidelines

Guideline Location Year PDF Website
Canadian Clinical Practice Guidelines Canada 2014 - Link
National Institute for Health and Care Excellence (NICE) UK 2018 - Link
American Psychiatric Association (APA) USA 2004, 2009 - • Guideline (2004)
• Guideline Watch (2009)
• Quick Reference
Veterans Affairs (VA) and Department of Defense (DoD) USA 2017 - Link

Dissociative Identity Disorder

Dissociative Identity Disorder Guidelines

Guideline Location Year PDF Website
International Society for the Study of Trauma and Dissociation International 2011 Link Link

Substance Use Disorders

Alcohol

Alcohol Use Disorder Guidelines

Guideline Location Year PDF Website
Canadian Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder Canada 2023 Link (see also: comment on sertraline use in AUD) Link
Canadian Guidelines on Alcohol Use Disorder Among Older Adults Canada 2020 - Link
British Columbia Centre on Substance Use (BCCSU) Canada 2019 Link Link
National Institute for Health and Care Excellence (NICE) UK 2011 - Link
American Psychiatric Association (APA) USA 2018 - Link
European Federation of Neurological Societies (EFNS) - Wernicke Encephalopathy Europe 2010 - Link

Opioids

Opioid Use Disorder Guidelines

Guideline Location Year PDF Website
Canadian Medical Association Journal (CMAJ) Canada 2018 - Link
BC Centre on Substance Use (BCCSU) Canada 2023 Link Link
META:PHI Canada 2019 Link Link
Canadian Guidelines on Opioid Use Disorder Among Older Adults Canada 2020 PDF Link
National Institute for Health and Care Excellence (NICE) UK 2007 - Link
American Psychiatric Association USA 2006, 2007 - • Guideline (2006)
• Guideline Watch (2007)
• Quick Reference

Benzodiazepines

Benzodiazepine Use Guidelines

Guideline Location Year PDF Website
Deprescribing.org Canada 2018 • For Patients
• For Prescribers 		• For Patients
• For Providers
Canadian Guidelines on Benzodiazepine Receptor Agonist Use Disorder Among Older Adults Canada 2019 PDF Link
Australian Prescriber Australia 2015 - Link

Cannabis

Cannabis Guidelines

Guideline Location Year PDF Website
Canadian Guidelines on Cannabis Use Disorder Among Older Adults Canada 2020 - Link
Canada's Lower-Risk Cannabis Use Guidelines Canada 2019 - Link
National Institute for Health and Care Excellence (NICE) UK 2019 - Link

Tobacco/Nicotine

Tobacco/Nicotine Guidelines

Guideline Location Year PDF Website
Canadian Medical Association Journal (CMAJ) Canada 2016 - Link
CAN-ADAPTT Guideline for Smoking Cessation Canada 2011 - Link
U.S. Public Health Service US 2008 - Link
Agency for Healthcare Research and Quality (AHRQ) US 2008 - Link
National Institute for Health and Care Excellence (NICE) UK 2018 - Link

Perinatal

Perinatal Mental Health Guidelines

Guideline Location Year PDF Website
BC Best Practice Guidelines for Mental Health in the Perinatal Period Canada 2014 PDF Link
American College of Obstetricians and Gynecologists (ACOG) Psychotropic Medication Guidelines USA 2008 PDF • Link (AAFP)
• Link (ACOG)
American Psychiatric Association (APA) and ACOG Depression Guidelines USA 2009 - Link
National Institute for Health and Care Excellence (NICE) UK 2014, 2020 - Link
British Association for Psychopharmacology (BAP) UK 2017 PDF Link
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Australia, New Zealand 2018 PDF Link

Child and Adolescent

Autism

Autism Guidelines

Guideline Location Year PDF Website
Canadian Medical Association Journal (CMAJ) Canada 2014 - Link
Canadian Paediatric Society (CPS) Canada 2019 - Link
National Institute for Health and Care Excellence (NICE) UK 2016 - Link
American Academy of Pediatrics (AAP) USA 2020 - Link

Enuresis

Enuresis Guidelines

Guideline Location Year PDF Website
Canadian Paediatric Society (CPS) Canada 2016 - Link
National Institute for Health and Care Excellence (NICE) UK 2010 - Link

ADHD

ADHD Guidelines

Guideline Location Year PDF Website
Canadian ADHD Resource Alliance (CADDRA) Canada 2020 Link Link
Canadian Journal of Psychiatry (Aggressive Behaviour) Canada 2015 - Link
National Institute for Health and Care Excellence (NICE) UK 2019 - Link
American Academy of Pediatrics (AAP) USA 2019 - Link

Eating Disorders

Eating Disorder Guidelines

Guideline Location Year PDF Website
International Comparison (Curr Opin Psychiatry) International 2017 - Link
Canadian Clinical Practice Guidelines (Children and Adolescents) Canada 2020 - Link
National Institute for Health and Care Excellence (NICE) UK 2017 - Link
American Psychiatric Association (APA) USA 2006, 2012 - • Guideline (2006)
• Guideline Watch (2012)
• Quick Reference

Body Dysmorphia

Guidelines

Guideline Location Year PDF Website
National Institute for Health and Care Excellence (NICE) UK 2005 - Link

Tics and Tourettes

Guidelines

Guideline Location Year PDF Website
Canadian Guidelines for the Evidence Based Treatment of Tourette Syndrome Canada 2012 Link -
American Academy of Neurology (AAN) USA 2019 - Link

ODD, Conduct Disorder

ODD and Conduct Disorder Guidelines

Guideline Location Year PDF Website
Canadian Journal of Psychiatry (Aggressive Behaviour) Canada 2015 - Link

Gender Dysphoria

Gender Dysphoria Guidelines

Guideline Location Year PDF Website
World Professional Association for Transgender Health (WPATH) International 2011 Link Link

Medical-Psychiatry

Wernicke Encephalopathy

Wernicke Encephalopathy Guidelines

Guideline Location Year PDF Website
European Federation of Neurological Societies (EFNS) - Wernicke Encephalopathy Europe 2010 - Link

Stroke

Stroke Guidelines

Guideline Location Year PDF Website
Heart and Stroke Foundation of Canada Canada 2019 PDF Link
National Health Service (NHS) UK 2012 - Link
American Heart Association (AHA) and American Stroke Association (ASA) USA 2016 Link -

Traumatic Brain Injury (TBI)

Traumatic Brain Injury (TBI) Guidelines

Guideline Location Year PDF Website
Evidence-Based Review of Moderate-to-Severe Brain Injury (ERABI) Canada 2007 Link Link
Ontario Neurotrauma Foundation Canada 2017 Link Link
British Columbia Medical Journal (BCMJ) Canada 2010 - Link
BMJ Open (Systematic Review) UK 2019 - Link
PsychiatricTimes (Expert Opinion) USA 2019 - Link
Tele-Rehabilitation Interventions through University-based Medicine for Prevention and Health (TRIUMPH) USA 2020 Link -

Agitation

Agitation Guidelines

Guideline Location Year PDF Website
National Institute for Health and Care Excellence (NICE) UK 2015 - Link
American Association for Emergency Psychiatry (AAEP) USA 2012, 2019 - • 2012 Guidelines
• 2019 Guidelines
• 2020 Review

QT Monitoring

QT Monitoring Guidelines

Guideline Location Year PDF Website
American Psychiatric Association (APA) USA 2020 Link Link
Association of Medicine and Psychiatry USA 2020 PDF

Somatic Symptom Disorders

Somatic Symptom and Related Disorders Guidelines

Guideline Location Year PDF Website
Cochrane Review International 2014 - Link

Sleep

Sleep Guidelines

AASM Clinical Practice Guidelines and Clinical Guidance Statements

Guideline Location Year PDF Website
American Academy of Sleep Medicine (AASM) USA - - Link

REM Sleep Behavior Disorder

REM Sleep Behavior Disorder (RBD) Guidelines

Guideline Location Year PDF Website
Canadian Medical Association Journal (CMAJ): Parasomnias Canada 2014 - Link
National Institute for Health and Care Excellence (NICE) UK 2017 - Link
American Academy of Sleep Medicine (AASM) USA 2010 - Link

Geriatrics

Geriatric Depression

Geriatric Depression Guidelines

Guideline Location Year PDF Website
Canadian Network for Mood and Anxiety Treatments (CANMAT) Canada 2016 - • Original: Link
• Correction: Link
Canadian Coalition for Seniors' Mental Health (CCSMH) Canada 2021 Link CCSMH Depression

Delirium

Delirium Guidelines

Guideline Location Year PDF Website
Canadian Coalition for Seniors' Mental Health (CCSMH) Canada 2006, 2014 • 2014 Update
• 2006 Guideline
• Pocket Card 		CCSMH Delirium
National Institute for Health and Care Excellence (NICE) UK 2010, 2019 - Link
American Geriatrics Society (AGS) USA 2015 - Link
Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the ICU USA 2018 - Link
Journal of the American Medical Association (JAMA) USA 2017 - Link
American Psychiatric Association (APA) USA 1999, 2004 - • Guideline (1999)
• Guideline Watch (2004)
• Quick Reference
Clinical Practice Guidelines for the Management of Delirium in Older People Australia 2008 - Link

Vascular Cognitive Impairment

Vascular Cognitive Impairment Guidelines

Guideline Location Year PDF Website
Canadian Consensus Conference on Diagnosis and Treatment of Dementia (CCCDTD) Canada 2020 - Link
Heart and Stroke Foundation of Canada Canada 2019 - Link

Dementia

Dementia Guidelines

Guideline Location Year PDF Website
Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD) - Diagnosis and Treatment Canada 2020 - Link
CCCDTD - Pharmacological Recommendations for Symptomatic Treatment of Dementia Canada 2012 - Link
Deprescribing.org (Bruyère Research Institute) and University of Sydney Deprescribing Guidelines International 2018 - Link
National Institute for Health and Care Excellence (NICE) UK 2018 - Link
American Psychiatric Association (APA) USA 2007, 2014 - • Guideline (2007)
• Guideline Watch (2014)
• Quick Reference

BPSD

Behavioural and Psychological Symptoms of Dementia (BPSD) Guidelines

Guideline Location Year PDF Website
British Columbia Best Practice Guideline for
Accommodating and Managing
BPSD 		Canada 2012 Link Link
Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD) Canada 2020 - Link
Canadian Coalition for Seniors' Mental Health (CCSMH) Assessment and Treatment of Mental Health Issues in Long-Term Care Canada 2006, 2014 • 2006 Guideline
• 2014 Update 		Link
National Institute for Health and Care Excellence (NICE) UK 2018 - Link
Treatment of Inappropriate
Sexual Behavior in Dementia 		UK 2016 - Link
American Psychiatric Association (APA) USA 2016 - Link
Deprescribing.org (Bruyère Research Institute) and University of Sydney Deprescribing Guidelines International 2018 - Link

Parkinson's

Guidelines

Guideline Location Year PDF Website
Movement Disorders Society (MDS) International 2019 - Link
Canadian Guideline for Parkinson Disease Canada 2019 Link Link

Substances

Older Adult Substance Use Guidelines

Guideline Location Year PDF Website
Canadian Guidelines on Benzodiazepine Receptor Agonist Use Disorder Among Older Adults Canada 2019 PDF Link
Canadian Guidelines on Alcohol Use Use Disorder Among Older Adults Canada 2019 PDF Link
Canadian Guidelines on Cannabis Use Disorder Among Older Adults Canada 2019 PDF Link
Canadian Guidelines on Opioid Use Disorder Among Older Adults Canada 2020 PDF Link

Geriatric Suicide

Geriatric Suicide Guidelines

Guideline Location Year PDF Website
Canadian Coalition for Seniors' Mental Health (CCSMH) Assessment of Suicide Risk and Prevention of Suicide Canada 2006 PDF Link

Personality Disorders

All Personality Disorders

Personality Disorder Guidelines

Guideline Location Year PDF Website
World Federation of Societies of Biological Psychiatry (WFSBP) International 2009 - Link

Borderline Personality

Borderline Personality Disorder Guidelines

Guideline Location Year PDF Website
Canadian Medical Association Journal (CMAJ) Canada 2012 - Link
National Institute for Health and Care Excellence (NICE) UK 2009 - Link
American Psychiatric Association (APA) USA 2001, 2005 - • Guideline (2001)
• Guideline Watch (2005)
• Quick Reference

Antisocial Personality

Antisocial Personality Guidelines

Guideline Location Year PDF Website
National Institute for Health and Care Excellence (NICE) UK 2009 - Link

Suicide

Suicide Guidelines

Guideline Location Year PDF Website
Canadian Journal of Psychiatry Canada 2007 - • Sakinofsky, I. (2007). The current evidence base for the clinical care of suicidal patients: strengths and weaknesses. Canadian journal of psychiatry, 52(6), 7S.
• Steele, M. M., & Doey, T. (2007). Suicidal behaviour in children and adolescents part 1: Etiology and risk factors. Canadian journal of psychiatry, 52(6), 21S.
• Steele, M. M., & Doey, T. (2007). Suicidal behaviour in children and adolescents Part 2: Treatment and prevention. Canadian journal of psychiatry, 52(6), 35S.
• Grek, A. (2007). Clinical management of suicidality in the elderly: an opportunity for involvement in the lives of older patients. Canadian Journal of Psychiatry, 52(6), 47S.
• Mamo, D. (2007). Managing suicidality in schizophrenia.
• Sakinofsky, I. (2007). Treating suicidality in depressive illness. Part I: current controversies. Canadian journal of psychiatry, 52(6), 71S.
• Sakinofsky, I. (2007). Treating suicidality in depressive illness. Part 2: does treatment cure or cause suicidality?. Canadian journal of psychiatry, 52(6), 85S.
• McMain, S. (2007). Effectiveness of psychosocial treatments on suicidality in personality disorders. Canadian journal of psychiatry, 52(6), 103S.
• Cardish, R. J. (2007). Psychopharmacologic management of suicidality in personality disorders. Canadian journal of psychiatry, 52(6), 115S.
• Sakinofsky, I. (2007). The aftermath of suicide: Managing survivors' bereavement. Canadian journal of psychiatry, 52(6), 129S.
• Sakinofsky, I. (2007). Caring for the suicidal patient. Canadian journal of psychiatry, 52(6), 5S.
National Institute for Health and Care Excellence (NICE) UK 2019 - Link
American Psychiatric Association (APA) USA 2003 - • Guideline
• Quick Reference
Canadian Coalition for Seniors' Mental Health (CCSMH) Assessment of Suicide Risk and Prevention of Suicide Canada 2006 PDF Link

Resources

For Clinicians

Research