Conceptual developments in mid-twentieth century medicine, the many factors known to influence course and outcome in schizophrenia, and recent systemic models of brain function all suggest the value of re-assessing the view of schizophrenia as biologically determined. Although the current view of schizophrenia as a brain disease, invoking the natural history model of disease, has mobilised research and public interest, it encourages a new biological determinism in thinking about schizophrenia which current evidence does not warrant and which restricts research and clinical advances.