Beyond Consensus, Beyond Closure: Rethinking Relapse in Schizophrenia Through a Multidimensional Lens

The recent international consensus on relapse in schizophrenia has provided an important step toward standardizing outcome definitions in clinical research. However, the subsequent scholarly exchange reveals persistent conceptual tensions regarding the nature of relapse and its measurement. In this brief article, we synthesize this exchange and argue that the current symptom-based framework, while methodologically robust, risks oversimplifying a fundamentally multidimensional and context-dependent phenomenon. We revisit the proposed SFR model—integrating symptoms, functioning, and risk/resource utilization—as a complementary framework that preserves standardization while enhancing clinical validity. We also examine the epistemological implications of privileging absolute thresholds over context-sensitive change and discuss the limitations of current editorial practices that constrain iterative scientific dialogue. We conclude that advancing the field will require moving beyond single-domain definitions toward layered models that reconcile methodological rigor with clinical reality. Importantly, we argue that current definitions risk prioritizing methodological convenience over clinical meaning, and that a multidimensional approach is necessary to bridge this gap.