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Spanish Journal of Psychiatry and Mental Health Two decades of progress in schizophrenia: Evolution, current insights, and futur...
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Available online 6 July 2026

Two decades of progress in schizophrenia: Evolution, current insights, and future directions

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Mario Alvarez-Jimeneza,b, Celso Arangoc, Benedicto Crespo-Facorrod,*
Corresponding author
bcrespo@us.es

Corresponding author.
, Manuel J. Cuestae, Paola Dazzanf, Peter Falkaig,h,i, Emilio Fernández-Egeaj, Michael F. Greenk, Oliver D. Howesl,m,n, Javier Labado,p, Patrick D. McGorryq,r, Peter McKennas, Robin Murrayl,n, Merete Nordentoftt, Jim van Osu, Michael J. Owenv,w, Rafael Penadésx, Edith Pomarol-Clotets, Iris E.C. Sommery, Til Wykesz,1
a Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
b Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
c Hospital Universitario La Paz, IdiPAZ, School of Medicine, Universidad Autónoma de Madrid, CIBERSAM, Madrid, Spain
d Department of Psychiatry, Universidad de Sevilla, Hospital Universitario Virgen del Rocío, IBiS-CSIC, CIBERSAM, Spain
e Servicio de Psiquiatría, Hospital Universitario de Navarra, Pamplona, Spain
f Social, Genetic & Developmental Psychiatry Centre, King's College London, Institute of Psychiatry Psychology & Neuroscience (IoPPN), UK
g Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
h German Center for Mental Health, Partner Site Munich-Augsburg, Augsburg, Germany
i Max Planck Institute of Psychiatry, Munich, Germany
j Department of Psychiatry, University of Cambridge, UK
k Department of Psychiatry and Biobehavioral Sciences, University of California, U.S. Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, Los Angeles, USA
l Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
m Psychiatric Imaging Group, MRC Laboratory of Medical Sciences (formerly MRC London Institute of Medical Sciences), Imperial College London, Hammersmith Hospital, London, UK
n South London and Maudsley NHS Foundation Trust, London, UK
o Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
p Department of Mental Health and Addictions, Consorci Sanitari del Maresme, Hospital Universitari de Mataró, UAB, Mataró, Spain
q Centre for Youth Mental Health, University of Melbourne, Orygen, Parkville, Australia
r The University of Melbourne, Melbourne, Victoria, Australia
s FIDMAG Germanes Hospitalàries Research Foundation, CIBERSAM, ISCIII, Barcelona, Spain
t Department of Clinical Medicine, University of Copenhagen, Senior Consultant Psychiatrist, Mental Health Centre Copenhagen, Director CORE (Copenhagen Research Center for Mental Health), Denmark
u Division Neuroscience, Utrecht University Medical Center, Utrecht, The Netherlands
v Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
w Neuroscience & Mental Health Innovation Institute, Cardiff University, Cardiff, UK
x Hospital Clinic Barcelona, Department of Clinical Psychology and Psychobiology, University of Barcelona, IDIBAPS, CIBERSAM, Spain
y Department of Neuroscience, University Medical Center Groningen, The Netherlands
z Institute of Psychiatry, Psychology and Neuroscience, King's College and South London NHS Foundation Trust, London, UK
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Abstract

Schizophrenia research has undergone substantial conceptual and clinical evolution over the past two decades, driven by advances in neuroscience, genetics, neuroimaging, cognition, psychopathology, public health and therapeutics. Despite these developments, major questions regarding the nature, heterogeneity, trajectory, and treatment of schizophrenia remain unresolved. In this viewpoint article, the Spanish Journal of Psychiatry and Mental Health (SJPMH) invited leading experts from different fields within schizophrenia research who have authored influential work and contributed significantly to the understanding and treatment of the disorder in recent years. Through concise and reflective perspectives, the contributors revisit some of the most relevant advances of the last two decades while discussing unresolved challenges and future directions. Together, these viewpoints provide a comprehensive overview of the evolving schizophrenia landscape and offer thoughtful and illuminating perspectives on the future of schizophrenia research and clinical care.

Keywords:
Schizophrenia
Neurodevelopment
Heterogeneity
Precision psychiatry
Translational research
Treatment innovation

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