Fifty years of applied clinical research: schizophrenia as an example

Researching the causes and treatment of a clinical condition involves the use of many conceptual and methodological approaches to obtain valid knowledge; these include nosology, neurobiology, psychology, and epidemiology. This is evident in the study of schizophrenia which was one of the first mental illnesses to be conceptualized as a medical disorder. We therefore use schizophrenia as an example of how progress has been made. In this essay, we discuss the history of research into schizophrenia since the 1960s. There were many challenges to overcome. First, the lack of a clear organic basis at the beginning of our period created the context for a huge turnover of ideas about what constituted the condition and where the pathology was located. Secondly, the tremendous social impact of the illness and the ethical difficulties involved in detaining patients against their will, led to criticism from both within and outside psychiatry. Thirdly, given the detrimental impact on physical, psychological, social and occupational functioning, schizophrenia attracted interest from a wide range of disciplines, ranging from neuroscientists interested in neuronal circuitry to anthropologists examining the person’s social world.