Ikigai is the Japanese concept of “what makes life worth living.” It might otherwise be described as a sense of fulfilment by pursuing one’s passions. Ikigai helped Milo Kato to feel reinvigorated and heal after an acute hospital admission for schizophrenia (doi:10.1136/bmj-2026-100399).1 Kato overcame the stigma of the lay definition of the condition, as a “split mind,” by achieving a better understanding of its scientific definition.We delve deep into the science of schizophrenia in our State of the Art review that examines advances in pathophysiology, management, and precision medicine (doi:10.1136/bmj-2026-635470).2 While the lifetime prevalence of schizophrenia is around 0.5%, lifespans are shortened by 15-20 years. The reasons include lifestyle, cardiometabolic changes related to long term drug treatment, and “unidentified intrinsic biological vulnerability.” The pathophysiology of schizophrenia is heterogeneous, and drug treatment doesn’t improve symptoms in a third of people. Cognitive behavioural therapy can be helpful.In an accompanying editorial, Das-Munshi and…
