Psychiatric illnesses such as schizophrenia, bipolar disorders, and major depression are recognized as placing the heaviest burden on society along with cancer and cardiovascular disease because the clinical courses of these serious psychiatric diseases are characterized by their chronicity and recurrence. Therefore, the years of disability caused by these diseases are considered to have a marked impact on populations. Despite the identification of many relevant genomic loci, the underlying molecular mechanisms of schizophrenia and other psychiatric diseases remain largely unknown. It has become increasingly clear that human postmortem brains are essential to investigate these mechanisms because molecular phenotypes likely to be relevant to the pathophysiology of these diseases, such as transcriptional changes and epigenetic modifications, are: 1) human-specific; 2) brain and brain region-specific; and 3) developmentally/age-specific. Moreover, recent evidence of somatic mutations in the brain based on analyzing human brain tissue is essential to understand how the genetic structure, including rare mutations, affects the molecular signatures of brain function.
 In 1997, we established a systematic postmortem brain bank for psychiatric illnesses, specializing in schizophrenia, as a first in Japan in order to understand and cure psychiatric diseases, and it currently maintains 53 brain tissue samples. Our Basic Concept is "Working together with users of psychiatric medication and their families" and the characteristics of our brain bank are as follows: 1) Operation through active participation by patients and their families, 2) Supported by a volunteer group, 3) Pre-registered donation of diseased and healthy donors through informed consent, and 4) Open research activities. In this review, we present the history and outline our practice of organizing the psychiatric brain bank in Japan, with some comments from people who registered as living donors. Considering the above, we discuss the possibility that our activities using the interactive research system created by both patients and researchers can contribute to the actual clinical field.
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