How to break the logjam in schizophrenia. A look beyond genetics

Despite recent advances in methodology, research in schizophrenia has reached an impasse. A new thrust for research in the field is proposed, and ways for testing its validity are indicated. The status of schizophrenia research is evaluated from the vantage point of six current scientific models for its etiology: genetic, ecological, developmental, learning theory, internal environmental, and neurophysiological (including neuroanatomical), Integration of these models is proposed based on the assumption that schizophrenic episodes occur in vulnerable individuals who under sufficient stress develop a time-limited episode from which all but a small proportion recover. However, even the recovered remain vulnerable to future episodes. Potential markers for vulnerability and for the beginning and end of episodes are classified according to the six etiological models from which they emanate. Recent research in vulnerability is summarized, and directions for future research are recommended.