We know more about schizophrenia than people think

It is time to assert that we know quite a lot about the biopsychosocial pathophysiology of schizophrenia. Copy number variations (CNVs) account for ~1% of all cases and up to 15% of those with co-morbid Learning Disability. More than 200 identified Genome Wide Associations Study (GWAS) ‘hits’ have subtle effects on neurodevelopment and synaptic plasticity, especially in the context of obstetric complications and childhood adversities. Such gene-environment interactions lead to subtle impairments of brain function and structure evident in high risk populations. Psychosis is precipitated by cannabis, other illicit drugs and stress in the vulnerable, accompanied by increasing dopamine turnover and reducing cortical thickness. Thus, perception and thought are less constrained by previous experience, promoting delusions and hallucinations. Greater than average risk factor burdens and continuing grey matter loss are associated with a poor prognosis.