Is it possible that a psychiatrist from over 50 years ago could do better than NICE recommendations for schizophrenia

Don't ask how I ended up reading about insulin-induced comas. I'd heard of them before because they're an example of the power of the randomised control trial which eventually proved how they should have never been used. Anyone reading that Wiki page could work that out though.

However, there's a useful snip from that page (this piece is a slight piss take btw).

"

When they were not in a coma, insulin coma patients were kept together in a group and given special treatment and attention; one handbook for psychiatric nurses, written by British psychiatrist Eric Cunningham Dax, instructs nurses to take their insulin patients out walking and occupy them with games and competitions, flower-picking and map-reading, etc.

"

The very least NICE could have done in their guidelines for the treatment of schizophrenia is a have a little recommendation like that.

The worst, most disabiling and dehabiliting mental illness had recommendations of CBTp (16 sessions of CBT for psychosis), arts therapy and family interventions in the psychological therapies and psychosocial interventions bit of the updated 2009 guidelines. But Sweet Fuck All (SFA) else. (sorry....inappropriate humour again...thank goodness...read on and you'll understand why I'm so thankful for this morning's inappropriate humour).

SFA is an accurate acronym. I can't remember their depression guidance and only briefly flicked through it but I'm fairly sure it would be unfair of me to use that acronym on those because, if I remember right, there were considerably more options. (my sarcastic mind wants to write, but then depression is so much worse than schizophrenia but really it's just more difficult to treat and society doesn't treat schizotypy whereas it does mild depression.)

I'm sure NICE might say that their recommendations were made on the highest evidence but I'm afraid the evidence is that talking with me is about as good as talking with a qualified CBTp therapist (which frankly is probably the most disturbing thing you've ever read). They also had no reason to disrecommend any of the other treatments, for example supportive psychotherapy or social skills training. They may also have recommended against counselling of all bloody things noting that if the client asked for it they could have it but my memory really is poor so it may not have been that well-established psychological therapy that was recommended against in favour of CBTp.

In the end SFA was all they recommended. I suspect that they wouldn't have recommended art therapies without a kick in the arse from one of the involvement 'tokens'.

I have the privilege of being a critic. I can sit from outside the process and read the end result, zoom in with my detail lens and pick out any little mistake without understanding the bigger picture. Sadly in the treatment of schizophrenia, guess work, non-therapeutic controls or...ugh.....perish the thought.....talking to me would be as good as talking to an experienced, trained CBTp therapist.