Rethinking schizophrenia
Nature volume 468, pages 187–193 (2010 )Cite this article
How will we view schizophrenia in 2030? Schizophrenia today is a chronic, frequently disabling mental disorder that affects about one per cent of the world’s population. After a century of studying schizophrenia, the cause of the disorder remains unknown. Treatments, especially pharmacological treatments, have been in wide use for nearly half a century, yet there is little evidence that these treatments have substantially improved outcomes for most people with schizophrenia. These current unsatisfactory outcomes may change as we approach schizophrenia as a neurodevelopmental disorder with psychosis as a late, potentially preventable stage of the illness. This ‘rethinking’ of schizophrenia as a neurodevelopmental disorder, which is profoundly different from the way we have seen this illness for the past century, yields new hope for prevention and cure over the next two decades.
The challenge of creating a vision of schizophrenia for 2030, which I attempt here, is a difficult one. There is certainly a risk in predicting scientific progress—the most important discoveries will probably be ones we cannot imagine today. But it is equally true that we can use past experience and the present state of knowledge to predict some aspects of the future. For schizophrenia, our knowledge base in 2010 is mostly based on clinical observation.
