Foundational guides to understanding schizophrenia, psychosis, and how the condition affects daily life.
When Franco Basaglia closed the asylum in Trieste, he replaced it with 24-hour community mental health centres. Fifty years on, the Trieste model is still studied as a benchmark for community psychiatry.
OverviewThe 'mad genius' idea is older than psychiatry. The actual research on schizophrenia and creativity is more interesting — and more nuanced — than either the romantic or the dismissive version suggests.
NeurosciencePrepulse inhibition tests how a small warning sound dampens the startle response. People with schizophrenia show less of this dampening — a finding that has shaped decades of research.
ResearchPET imaging measures neurotransmitter activity directly in the living brain. It has provided some of the strongest evidence for the dopamine hypothesis — and now points to glutamate and inflammation as well.
FAQSchizophrenia in women tends to begin later than in men, often involves more mood symptoms, and is influenced by hormonal cycles. There is also a second onset peak around menopause.
Brain circuitsThe salience network helps the brain decide what deserves attention and switches between internally and externally focused modes. In schizophrenia, both functions appear disrupted.
MythsSchizophrenia is often described as 'rare,' but the WHO estimates roughly 24 million people worldwide live with it — a public health issue of substantial scale.
DisparitiesFirst-generation immigrants and their children carry an elevated risk of psychosis — and also a more complex path through any health system. Language, documentation, and trauma all shape what schizophrenia care looks like.
InternationalThe WHO Comprehensive Mental Health Action Plan 2013–2030 is the closest thing the world has to a global blueprint for community-based, rights-respecting mental health care. Here's what it says and where progress stands.
PreventionEarly intervention services for psychosis began in Australia in the 1990s and now exist worldwide. Here is what the leading international models look like.
DiagnosisSchizophrenia is one of the highest-stakes diagnoses in medicine — and not always the right one. Here is when a second opinion is reasonable and how to actually get one.
OverviewSchizophrenia exists everywhere humans live, but its long-term course is not identical across cultures. The WHO international studies gave us some of psychiatry's most important — and contested — cross-cultural findings.
DifferentialThree diagnoses, one diagnostic question: how do mood symptoms and psychotic symptoms relate to each other over time? The answer points to schizoaffective, schizophrenia, or bipolar.
Early onsetCoordinated Specialty Care (CSC) is a team-based, evidence-supported model for first-episode psychosis. For young people, it dramatically improves outcomes.
ResearchFunctional MRI lets researchers watch the brain at work. In schizophrenia, two decades of fMRI studies have changed how we think about brain networks — but it is still not a diagnostic test.
DisparitiesMost US counties have no practising psychiatrist. For rural Americans with schizophrenia, the work of getting care is often the work of bridging miles, broadband gaps, and a workforce shortage that is decades deep.
InternationalSchizophrenia affects about 24 million people worldwide and contributes a disproportionate share of years lived with disability. Here's what the global numbers tell us — and what they don't.
OverviewSchizophrenia is highly heritable — but no single gene 'causes' it. A clear-eyed look at the genetic evidence as it stands in 2026, and what it does and doesn't mean for families.
Brain circuitsThe default mode network is the brain's self-referential, mind-wandering circuit. In schizophrenia, it shows hyperconnectivity at rest and fails to deactivate during tasks, contributing to symptoms.
DiagnosisMRI and PET scans show real differences between groups of people with and without schizophrenia, but they cannot diagnose any individual. Here is what imaging can and cannot do.
DifferentialPsychosis in an older adult can be late-onset schizophrenia, a dementia, delirium, or several other conditions. The differences guide treatment.
FAQSchizophrenia in men typically begins in the late teens or early twenties, with more prominent negative symptoms and higher rates of substance use than in women. Treatment principles are similar, but presentation differs.
Differential diagnosisBrief psychotic disorder is a short, often dramatic episode of psychosis that fully resolves within a month. It's distinct from schizophrenia and usually has a much better prognosis.
NeuroscienceMRI studies have shown small but consistent brain volume differences in schizophrenia. The findings are real — but interpreting them honestly is more nuanced than the headlines suggest.
PreventionDuration of untreated psychosis (DUP) is one of the most consistent predictors of long-term outcome in schizophrenia. Reducing it is one of the field's clearest goals.
DisparitiesCities have more psychiatrists per capita — and also more fragmented care, more emergency-department reliance, and worse outcomes for many of the most vulnerable patients. Density does not automatically equal access.
Brain circuitsDecades of PET imaging have shown elevated presynaptic dopamine in the striatum of people with schizophrenia. The associative striatum, not the limbic striatum, is where the abnormality is largest.
ResearchCopy number variants are larger structural changes in DNA — duplications or deletions of whole gene-containing segments. A handful are now established as strong, rare risk factors for schizophrenia.
DisparitiesSchizophrenia is not a one-shape illness. Onset, course, treatment response, and side-effect risk all differ between men and women — and ignoring these differences leaves both groups under-served.
DiagnosisNeuropsychological testing measures the cognitive strengths and weaknesses of schizophrenia in detail — useful for treatment planning, school accommodations, and tracking change.