Henry Nasrallah, Rajiv Tandon and Matcheri Keshavan

About the CURESZ Foundation Schizophrenia Colloquia

The CURESZ Foundation is pleased to have collaborated with board members Dr. Rajiv Tandon, Dr. Henry Nasrallah and Dr. Matcheri Keshavan to bring together some of the best researchers and clinicians in the world to discuss the future of research into schizophrenia. The colloquia are titled “Reinventing Schizophrenia: Updating the Construct.”

About Schizophrenia

Affecting over 25 million people globally, schizophrenia is arguably the mental illness that has the most profound adverse impact on the ability of individuals to live productive and meaningful lives. Despite much investment over the past century, progress in our understanding of this condition has been slow and treatment development has yielded only modest improvements, with less than 20 percent of adults with schizophrenia around the world fully employed and independent today. Persons with schizophrenia continue to experience double the standardized mortality of the general population with approximately 15-year shortening of their life span. Over the approximately 125 years of intensive study, we have learned much about the nature of schizophrenia (etiology, pathophysiology, clinical manifestations, course, treatment, outcome), but we now seem to be at an impasse. This is despite the availability of powerful tools to investigate the human brain (mapped genome, artificial intelligence, range of imaging technologies, etc.).

2022 Colloquia

With the objective of making meaningful headway in breaking through the logjam, we assembled a group of 50 international experts and initiated a three-phase international project “Reinventing Schizophrenia: Updating the Construct” in 2022 (details in Tandon et al., 2022, 2023). We invited commentaries from these experts on key questions in the field and compiled them in a special issue of Schizophrenia Research (Volume 242 published in April, 2022).

After completion of phase-1, we conducted a set of three 6-hour structured virtual colloquia between July-September, 2022 that addressed three fundamental issues that needed to be resolved in order to break through the impasse in understanding and treatment development:

  1. What do we know about schizophrenia (“just the facts”) and what they tell us about its nature
  2. What is/are the current models of schizophrenia- definition, assumptions, explanatory and predictive potential, testability, comparisons
  3. What are current and emerging research modalities and approaches and how can they be most effectively applied to addressing key questions that need to be answered in order to more fully characterize schizophrenia and develop more specific, efficacious treatments

Each of these virtual colloquia had 16-18 participants (carefully selected from the experts to address specific issues in the particular colloquium), and a detailed agenda with a set of ten focused presentations each followed by structured discussions. Much preparatory work preceded each virtual colloquium. The proceedings of each virtual colloquium were summarized.

2023 Colloquia

After completion of phase-1, a three-day in-person colloquium (Michigan Schizophrenia Colloquium) was conducted in Detroit, Michigan in 2023, in which 20 selected experts participated. Each of the sessions provided rich discussion and a set of take-home points and specific recommendations. Two major next steps were defined:

  1. Dissemination of results of the project thus far to both clinical and research audiences
  2. Continuing the expert colloquium process to further refine recommendations for specific needs and for specific audiences

With regard to the second task, the following actions were recommended:

  1. Three mini-colloquia on focused topics with group of 12-15 specifically selected experts in 2024
  2. Follow-up colloquium of entire group in 2025

2024 Colloquia

In 2024, the CURESZ Foundation organized three colloquia in New York, Istanbul, Turkey and Bali.

The New York mini-colloquium “Unmet Therapeutic Needs in Schizophrenia” with 10 faculty and four attendees from Boehringer Ingelheim was conducted on May 3, 2024. There was a critical review and vigorous discussion of precise definition of unmet needs, current strategies towards addressing these, best methods to address them today, and optimal approaches to develop better ones for the future. Several concrete deliverables from the mini-colloquium were outlined and implementation responsibilities were assigned, and timelines were defined.

The Istanbul Colloquium, “Updating Diagnosis: Where Do We Go from Here” was congregated on June 4, 2024. Two additional articles are in preparation/review. The follow-up recommended actions are planned:

  1. White Paper on Key Questions and Challenges in the Study of Schizophrenia
  2. Research Agenda for Schizophrenia, Circa 2025 (how to more effectively develop agents/strategies to address unmet therapeutic needs will be an important section)
  3. Guidance for Clinicians for Assessment and Treatment of Schizophrenia (segment on meeting unmet needs Today will be one key section)

The Bali colloquium was the first of its kind in the Asia Pacific Zone and introduced the agenda and hoped-for deliverables, on December 4, 2024, titled “Addressing Cross Cultural Challenges.” The presentations by the various presenters were well-received and the discussions were extremely candid and productive. The following is a summary of what was agreed upon and action items:

  1. Participants agreed that the term “schizophrenia” should be retained for now as there is no currently better alternative, but concurrently felt the term was unsatisfactory; a change in name should await clarification of the concept.
  1. There was broad agreement of the “western” consensus conceptualization of schizophrenia (as articulated in the 2024 Schizophrenia Research article- this had been reviewed by all attendees) with the caveat that data about some aspects from the Asia-Pacific suggested minor variations or were lacking- “there are some differences in our data and we just don’t have much data to support or contradict the findings from the west”- on much “we just don’t know” – etiology, causation factors, treatment responses, and genetic research, neurobiology, or a biomarker for the disorder.
  1. There was agreement that schizophrenia is a group of disorders, and not a singular condition, with the following traits: No specific markers; No sufficient pathology; No sufficient etiology; Poor etiopathogenesis; Poor pathophysiologic chain; Extreme heterogeneity; Many diseases; No element is necessary or sufficient; The boundaries are fuzzy; Schizophrenia has multiple psychopathological dimensions; Psychosis should be still remain primary basis for its identification/diagnosis.

2025 Colloquia

In 2025, the CURESZ Foundation plans to conduct three colloquia in Los Angeles, California, Berlin, Germany, and Detroit, Michigan.

The Los Angeles colloquium will take place on May 16, 2025, titled “Do all roads lead to (through) Dopamine?” We look forward to summarizing the results of this meeting.