50 years after the introduction of neuroleptic treatment we are still struggling efficient remission in about 50% of the patients suffering from schizophrenia. The residual symptoms constitute of negative symptomatology including cognitive dysfunction leading to disturbed social and occupational performance. During the initial months and years of the illness it is clinically impossible to predict the long-term outcome of schizophrenia. Therefore, biomarkers are needed to dissect subgroups in order to find targeted treatment options for these subgroups. Recent studies show that it seems to be likely possible, based on clinical, neuropsychological and imaging data, to predict which patient will transit into psychosis with a high degree of accuracy. Very recent results based on structural imaging data demonstrate that patients with a favourable compared to an unfavourable long-term outcome can be predicted in the early phase of the illness.

This lecture will focus on possible biomarker approaches in schizophrenia and outline necessary steps to have useful biomarker in future as has been shown in other medical disciplines like gynaecology or oncology.