Medical guideline development is a generally accepted quality assuring procedure in health care. Recent research however showed several methodological shortcomings and a disappointing implementation in actual medical practice. Guideline development in Dutch psychiatrie might be facilitated by these recent research findings by using them in new development models. It is however unclear if psychiatry, compared to the other medical specialities, will produce its own methodological problems. In view of all these questions it is realistic to expect guideline development to take a long time before a methodologically acceptable model, that will result in practically employable guidelines, will be reached.