Reframing schizophrenia as a neurodevelopmental syndrome: The scientific and social imperative

Abstract

Background Schizophrenia is traditionally classified as a serious mental illness (SMI), emphasizing chronicity and disability. However, growing evidence supports that it also shows features of a neurodevelopmental syndrome, highlighting disruptions in early brain development and a diverse spectrum of trajectories. Objective This paper proposes expanding the conceptualization of schizophrenia as both an SMI and a neurodevelopmental syndrome. Methods We review biological, clinical, and epidemiological evidence supporting a neurodevelopmental model of schizophrenia. We then propose a three-pronged strategy to operationalize this reframing: (i) reclassification in the ICD-11 and DSM-5 as a neurodevelopmental syndrome; (ii) renaming to reflect established and evolving scientific evidence; and (iii) reshaping societal narratives so schizophrenia is understood as a developmental condition that remains modifiable. Results A neurodevelopmental framing may advance access, quality, and equity in schizophrenia care. Conclusion Reframing schizophrenia as a neurodevelopmental syndrome reflects modern science and, based on precedent from other countries, could catalyze systemic changes to improve care, access, and equity.