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Schizophrenia Bulletin Advance Access originally published online on February 17, 2009
Schizophrenia Bulletin 2009 35(3):528-548; doi:10.1093/schbul/sbn187
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© The Author 2009. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

The Neurodevelopmental Hypothesis of Schizophrenia, Revisited

S. Hossein Fatemi1,2,3 and Timothy D. Folsom2
2 Division of Neuroscience Research, Department of Psychiatry
3 Departments of Pharmacology and Neuroscience, University of Minnesota, Minneapolis, MN

1 To whom correspondence should be addressed; 420 Delaware St SE, MMC 392, Minneapolis, MN 55455; tel: 612-626-3633, fax: 612-624-8935, e-mail: fatem002{at}umn.edu.

While multiple theories have been put forth regarding the origin of schizophrenia, by far the vast majority of evidence points to the neurodevelopmental model in which developmental insults as early as late first or early second trimester lead to the activation of pathologic neural circuits during adolescence or young adulthood leading to the emergence of positive or negative symptoms. In this report, we examine the evidence from brain pathology (enlargement of the cerebroventricular system, changes in gray and white matters, and abnormal laminar organization), genetics (changes in the normal expression of proteins that are involved in early migration of neurons and glia, cell proliferation, axonal outgrowth, synaptogenesis, and apoptosis), environmental factors (increased frequency of obstetric complications and increased rates of schizophrenic births due to prenatal viral or bacterial infections), and gene-environmental interactions (a disproportionate number of schizophrenia candidate genes are regulated by hypoxia, microdeletions and microduplications, the overrepresentation of pathogen-related genes among schizophrenia candidate genes) in support of the neurodevelopmental model. We relate the neurodevelopmental model to a number of findings about schizophrenia. Finally, we also examine alternate explanations of the origin of schizophrenia including the neurodegenerative model.

Keywords: brain / genes / animal model / pathology / epidemiology / antiviral model / schizophrenia


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