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What We Know About Schizophrenia—Introduction

When it comes to the latest schizophrenia findings, does it feel like you're falling behind and can't get up? A simple exercise in PubMed can help to explain why. Twenty years ago you may have been able to keep up with the 1,200 or so articles on schizophrenia published in that year. All you had to do then was read 24 articles per week. By 1999 that number had doubled to more than 2,400. If trends continue the number of publications on schizophrenia will have doubled again by next year. To be thorough, you’ll need to read about 90 articles per week. Unless your time and energy are doubling as well, you probably are not keeping up. [Editor's Note: SRF's Current Papers section is designed to help you zoom in on papers of interest. We search PubMed and post a week's worth of citations on Fridays.]



A growing literature signals an active research area. But you could be forgiven for wondering what it all means. How have the 50,000 schizophrenia articles published in the last two decades changed our understanding of the disorder? Have they modified our ideas about who is diagnosed, what causes it, how to treat it, or how to cure it? Or is all this publishing just so much sound and fury?

Our efforts to compile the bedrock of facts about schizophrenia grew out of the sense that while the amount of information about schizophrenia was growing, our understanding of the disorder might not be. That is, the effort to be "cutting edge" in our research has led to a neglect of the organizing principles of research in schizophrenia, the explanatory theories. Much ink has been spilled about the relative importance of theory, but suffice it to say that Poincaré had the right of it 100 years ago when he wrote, "Science is built up with facts, as a house is with stones. But a collection of facts is no more a science than a heap of stones is a house" (Poincaré, La Science et l'Hypothèse, 1908). So, with a tip of our hats to Poincaré, we set out to address the question, What are the fundamental facts that we have to build theories with today?

Observing the change in the fundamental facts over the past 20 years, or 50,000 published studies, is not an arbitrary choice. Two decades ago a team led by Richard Wyatt at St. Elizabeth’s Hospital compiled a document titled, "Schizophrenia, just the facts" for the inaugural issue of Schizophrenia Research. This wasn’t the first, nor was it the most recent such list. It was the most explicit, though, in its goal to compile a broad compilation of what was known about the disease at the time. Living up to this legacy would require insight, acumen and high technology. We decided to settle for sandwiches, salad and a really big white board.

With these inducements in place, 12 schizophrenia researchers from the University of Minnesota and the Minneapolis Veteran's Administration gathered around a large table on a stormy evening in May. Time slipped by while we struggled to distill the years of professional experience in the room into a pithy, quixotic consensus of facts to spur discussion here on the Schizophrenia Research Forum. More time was spent afterward, hunting down references and calculating effect sizes. But the work is not yet complete. We hope you will take the time to look over the results of our initial effort and then make further contributions to expand (or contract) the list. Ultimately, the list of facts will be used as part of a larger exercise to be published in Schizophrenia Bulletin in November 2008. That issue will feature a special section devoted to theory, and the ability of different theories of schizophrenia to account for the facts that we, as a community, believe they should account for. So, weigh in, leave a comment on one of the facts presented, a correction, or an additional fact to consider for inclusion. The better we sift this heap of stones, the better will be the house we build from them.

Angus MacDonald and S. Charles Schulz
Co-Editors, Future Special Issue on Theory in Schizophrenia, Schizophrenia Bulletin.
The Minnesota Consensus Group included Angus MacDonald, S. Charles Schulz, S. Hossein Fatemi, Irving I. Gottesman, William Iacono, Daniel Hanson, Kelvin O. Lim, Peter Milev, Steve Olson, Scott Sponheim, John Vuchetich, and Tonya White.

 
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