• spent almost $12 billion in health, welfare,and loss of productivity costs for psychosis;
• potentially lost over 600 lives from suicide alone; and
• another 15,000 schizophrenia sufferers and thousands more families and carers will be affected.

The associated problems such as unemployment, crime and substance abuse will continue to rise and place enormous stress and demand on current and future support services.

Why the answer can now be found

Unlike dementia, cancer or cardiovascular disease that primarily disable or shorten the lives of older people, psychotic disorders usually permanently disable young people. In the case of schizophrenia recent data indicates that current approaches to treatment avert only about 13% of the total aggregated burden due to this disease, and that even if services were given unlimited funding they could only aim to avert about 22% of the total aggregated disability (Andrews et al. 2003, Brit J Psychiatry, 183, 427-435).

Not only is current treatment relatively ineffective, it is extremely inefficient, costing in the order of $200,000 to avert one year of disability. Now that the scientific tools are available to conquer the psychotic disorders, these findings represent nothing short of a public health emergency, demanding immediate action.

Only a decade ago the causes of Alzheimer’s disease were virtually unknown and there were no effective treatments. Substantial funding in the last ten years has resulted in an understanding of the molecular basis of Alzheimer’s disease and, currently preventative treatments are in clinical trial.

The community now needs to recognise that schizophrenia and bipolar disorder also require a concerted research effort aimed at prevention. As with Alzheimer’s disease, usually those affected by these disorders cannot advocate for themselves. This heightens our responsibility to take urgent action on their behalf.

Until very recently one could not be confident that increased investment in research into psychotic disorders would yield results as quickly as it has for Alzheimer’s disease. The reason for this is that although the general location of a number of putative susceptibility genes for the psychoses had been found, not a single gene was precisely identified.

Fortunately, in the last few years this situation has fundamentally changed with the discovery of eight to ten putative susceptibility gene variants. It cannot be over-emphasised how the prospects for discovery in the psychotic disorders have been radically changed by this advance.

For schizophrenia, there is increasing evidence that variants of the following genes mediate or modify susceptibility to the disease:

1. NRG-1 also known as neuregulin-1
2. DTNBP-1 also known as dysbindin
3. G72 (a novel primate gene)
4. DAAO short for D-aminoacid oxidase
5. RGS-4, short for regulator of G-protein signalling-4
6. PRODH, short for proline dehydrogenase
7. DISC-1, short for Disrupted In Schizophrenia-1
8. GRM-3 encoding a metabotropic glutamate receptor
9. PPP3CC encoding the calcineurin gamma subunit
10. COMT, short for catechol-O-methyl transferase

All of the above genes play a role in brain development and maturation, probably through their influence on synaptic neuroplasticity.

The investigation of the functional significance of these genes in a multi-level, multidisciplinary research program using a combination of genomics, proteomics, animal models, in vivo neuroimaging and spectroscopy, and clinical studies has the potential to identify preventative approaches to the treatment of psychotic disorders.

The establishment of the Australian Psychosis Research Network will mark the beginning of a unique national effort mobilising Australia’s world-class expertise and resources against the onset and tragic consequences of psychotic disorders.

Without such an effort, the annual toll taken by psychosis on our young people will continue unchecked.