Schizophrenia: Time for a Name Change?
What's in a name? Well, quite a lot if it happens to be schizophrenia. Public misunderstanding of the term continues to be fuelled by lack of proper education and by media portrayals of the association of schizophrenia with criminality and violence or vaguely disturbing and unreliable behavior.
I was recently drawn to an article by David Sweetsur, a diagnosed schizophrenic, who as a result of his own experiences and research questions whether it isn't time to rename schizophrenia?
David's story will probably resonate with others. After years of diagnostic ambivalence ranging from depression, to bipolar and finally schizophrenia, he found himself labelled with probably the most misunderstood and stigmatized of all the mental illnesses. "Every time I say the word it seems to hang in the air like a bad smell," he writes.
In his article, David talks about how he looks for alternatives. He is encouraged to find that alternatives have actually been suggested, notably "integration disorder" and "dopamine dysregulation disorder". But it was when David happened upon the experiences of Japanese people with schizophrenia that he realized how profound the effects of a change of name could be.
Spurred on by the request of a patient families group to change the term for schizophrenia, ‘seistrin bunretsu byo' (mind split disease) the Japanese Society of Psychiatry and Neurology adopted the term ‘togo shitcho sho' (integration disorder) in 2002. In just seven months 78 percent of all new cases were referred to by the new term. Moreover, a huge 86 percent of all psychiatrists found the new term more acceptable in terms of how the terminology could be used to explain the diagnosis to patients.
Nearer home David speculates as to whether the stigma attached to a diagnosis might put some psychiatrists off its use? David feels his own experience reflected this and may have needlessly delayed earlier diagnosis and treatment.
The Japanese experience points to the vast majority of psychiatrists finding their new terminology in keeping with our current understanding. They find more patients give their consent to treatment and are more likely to comply with treatment. In turn, patients feel more promise towards a goal of social integration and less stigma.
So, let me reiterate David's own question, "is it time to rename schizophrenia"?
Sweetsur, D (2008) Is it Time to Rename Schizophrenia? Mental Health & Occupational Therapy. 13 (2) 56.