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Credit: Sue Morgan

The cover of this Outlook vividly conveys the sense of fragmentation experienced by many people with schizophrenia. The artist, Sue Morgan, has been living with the condition for about twenty years, although she is now in remission. Morgan tried in this illustration to “convey the sense of horrible overwhelmingness” of living with this condition, which still confounds researchers trying to both treat the symptoms and fix the underlying biology. The lines connecting to the head, she says, “express the invisible signals and connections that I can tap into” (see "Designing the cover").

Science is finally beginning to offer slivers of hope. Studies of the language difficulties faced by schizophrenia patients are revealing clues to how the disorder affects the brain (page S4). Researchers have identified hundreds of genes associated with the disease (S6) — although these findings are creating new puzzles as they solve old ones (S20).

Frustratingly little progress has been made in drug development for twenty years, raising questions about the best research strategy (S18). Help could come in the form of better animal models (S8). And treatments may be close for the so-called negative symptoms of schizophrenia — the emotional withdrawal that can be as disabling as the psychosis more often associated with the disease (S10).

The disorder typically strikes with full fury in young adults, but warning signs are often evident before then, offering the possibility of earlier intervention (S12). And lessons might be learned from the developing world, where, paradoxically, people with schizophrenia tend to have better outcomes than in richer countries (S14). Scientists are also figuring out why the disease is associated with accelerated ageing (S16). Imaging systems are offering clues as to what goes on in brains affected by this disorder (see "What’s in my head?").

This Outlook was produced with support of a grant from Otsuka Pharmaceutical Development and Commercialization, Inc. As always, Nature Publishing Group retains sole responsibility for editorial content.

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Brody, H. Schizophrenia. Nature 508, S1 (2014).

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