Rethinking schizophrenia

• Published in: Nature (London) Vol. 468; no. 7321; pp. 187 - 193
• Main Author: Insel, Thomas R.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 11.11.2010; Nature Publishing Group
• Subjects: 631/378/1689/1761; 692/308; 692/699/476/1799; Antipsychotic drugs; Care and treatment; Chronic illnesses; Cognition Disorders - complications; Cognition Disorders - prevention & control; Cognition Disorders - therapy; Development and progression; Dopamine; Drug therapy; Forecasts and trends; Health aspects; History, 19th Century; History, 20th Century; History, 21st Century; Hospitals; Humanities and Social Sciences; Humans; Judicial system; Medical research; Medicine, Experimental; Mental disorders; Models, Neurological; multidisciplinary; Name changes; Patient outcomes; perspective; Psychotropic drugs; Schizophrenia; Schizophrenia - genetics; Schizophrenia - history; Schizophrenia - physiopathology; Schizophrenia - therapy; Schizophrenic Psychology; Science; Science (multidisciplinary); United States
• ISSN: 0028-0836; 1476-4687; 1476-4687
• DOI: 10.1038/nature09552

Schizophrenia today: three views of the future Three Perspectives in this issue cover different aspects of the current state of our knowledge about schizophrenia. Thomas Insel, director of the US National Institute of Mental Health in Bethesda, Maryland, outlines a new approach to schizophrenia that could in time lead to new treatments. He calls for schizophrenia to be emphasized as a neurodevelopmental disorder in which psychosis is a late — and potentially curable — stage. Andreas Meyer-Lindenberg, director of the Central Institute of Mental Health in Mannheim, Germany, explains how neuroimaging and other systems-level techniques can help develop future treatment. And Jim van Os, Gunter Kenis and Bart Rutten review our knowledge of the environmental factors that influence schizophrenia risk, and the major challenges that will be involved in teasing them out. 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.