New Approaches to Clinical Research for People with Schizophrenia

Clinical research in schizophrenia has long been constrained by exclusionary trial designs, chronic underfunding, and a narrow focus on short-term positive symptom reduction. Most people living with schizophrenia — particularly those with treatment-resistant illness — remain ineligible for trials, while cognitive impairment, negative symptoms, and functional disability that drive long-term burden go largely unmeasured. A fundamental shift is required. Future trials must adopt multi-domain evaluation frameworks capturing positive and negative symptoms, cognition, and real-world functioning in parallel. Platform trials, adaptive designs, and Sequential Multiple Assignment Randomized Trials offer the methodological sophistication needed to deliver meaningful, patient-centred evidence for this neglected population.