The Cochrane Schizophrenia Group: preparing, maintaining and disseminating the evidence for interventions used for people with schizophrenia.

The Cochrane Collaboration's Schizophrenia Group has, since 1994, been preparing, disseminating and updating high quality systematic reviews of randomized controlled trials of interventions for people with schizophrenia. The aim of this study was to summarise the Group's methods and its output in terms of effective interventions for people with schizophrenia, and to evaluate this evidence from the perspective of the care of people with schizophrenia in developing countries. This was achieved by a search and narrative synthesis of the Cochrane Schizophrenia Group's module and database of systematic reviews in Issue 4, 2003 of the Cochrane Library. The results found that the Schizophrenia Group had, by December 2003, published 100 completed reviews, or protocols for reviews, of pharmacological, physical, spiritual, psychosocial interventions and health care delivery pertaining to those with schizophrenia. While evidence of efficacy is present for many of these interventions, evidence of efficiency is less compelling. The reviews in the Cochrane Library provide the currently best available evidence on the value of interventions for people with schizophrenia, but this may not generalize to developing country settings. Pragmatic randomized trials of interventions and evaluations of systems of health care delivery relevant to developing countries are required if the care of those with schizophrenia in these settings is to improve.