Towards an aetiological classification of schizophrenia.

The genetic contribution to schizophrenia is widely accepted, yet none of the proposed models of transmission has been convincing. Schizophrenia is generally viewed as aetiologically homogeneous with the exception of supposedly rare "phenocopies" associated with organic brain lesions and without a family history. However, up to one-third of schizophrenics have enlarged cerebral ventricles, and this appears to be a consequence of environmental damage. Although the aetiology of schizophrenia comprises genetic and environmental components acting in variable proportions, a simple division into familial and sporadic cases would facilitate research. Families with several ill members will be most valuable for molecular genetic studies, while the new brain imaging techniques should be particularly directed towards sporadic cases.