I had the opportunity to attend the 4th Biennial Conference of the Schizophrenia International Research Society (SIRS), held April 5-9, 2014, in Florence, Italy. The theme of the meeting was “Fostering Collaboration in Schizophrenia Research.” Approximately 1500 delegates from across the globe attended the meeting, and there were about 300 oral presentations and over 800 poster presentations. One of my “take-home messages” from the meeting (a sentiment echoed by other attendees from my department) was the absence of a major breakthrough in the field with regard to diagnosis or treatment. Nonetheless, through my lens as an eternal optimist, despite the lack of seminal findings, there is evidence of progress.
One potential impediment to progress in schizophrenia research is the use of symptom-based diagnosis, which itself was not designed for biological validity. Towards “precision medicine for psychiatry,” the NIMH Research Domain Criteria project aims for a diagnostic system based on improved understanding of the biological and psychosocial basis of mental disorders.2
Another “take-home message”: the immunology of schizophrenia has become a credible area of research focus—one that is fast-moving towards translation of findings into therapeutic interventions. At the SIRS meeting, I attended a symposium titled “Potential Role of NMDA-Receptor Antibodies in Schizophrenia,” in which the question was asked, “Is NMDA-receptor encephalitis a schizophrenia subtype?”3 And while the jury is still out regarding a definitive answer, the question itself represents an important step towards “precision medicine” and an improved understanding of the pathophysiology of psychotic symptoms.