Studies examining comparative outcomes of schizophrenia in high-income countries with those in low- and middle-income countries remain of interest to researchers and may be of value in understanding some environmental factors that influence the course and outcome of the disorder. The view that the disorder has a better outcome in low- and middle-income countries compared with high-income countries, even though widespread and supported by a set of World Health Organization (WHO) studies, requires further testing and exploration. Unfortunately, although not insurmountable, the obstacles for such studies both in terms of implementation and interpretation are considerable.