For decades, the term refractory psychosis has been widely used, but not clearly defined. Although the exact mechanisms by which treatment-resistance is developed are unknown, some factors will lead to bigger vulnerability to present it. It remains unclear if it is just a severe extreme at the end of the psychosis spectrum, or a subtype of schizophrenia. Objective: To determine if there is current consensus in the concept of refractory psychosis. Methods: Review of different guidelines about it

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... (EMEA, SIGN, NICE, BPA, APA, CPA and WFSBP) and comparison of their definitions and approach designs. Results: Consulted guidelines show differences in the way they define refractory psychosis, but uniformity in their management proposal. Conclusion: There is no consensus in the operational definition of treatment resistant psychosis.