Renaming schizophrenia: A Japanese perspective

Department of Psychiatry, Tohoku Fukushi University, 1-8-1, Kunimi, Aoba-ku, Sendai-shi, Miyagi 981-8522, Japan.
World psychiatry: official journal of the World Psychiatric Association (WPA) (Impact Factor: 14.23). 03/2006; 5(1):53-5.
Source: PubMed


In order to contribute to reduce the stigma related to schizophrenia and to improve clinical practice in the management of the disorder, the Japanese Society of Psychiatry and Neurology changed in 2002 the old term for the disorder, "Seishin Bunretsu Byo" ("mind-split-disease"), into the new term of "Togo Shitcho Sho" ("integration disorder"). The renaming was triggered by the request of a patients' families group. The main reasons for the renaming were the ambiguity of the old term, the recent advances in schizophrenia research, and the deep-rooted negative image of schizophrenia, in part related to the long-term inhumane treatment of most people with the disorder in the past. The renaming was associated with the shift from the Kraepelinian disease concept to the vulnerability-stress model. A survey carried out seven months after renaming in all prefectures of Japan found that the old term had been replaced by the new one in about 78% of cases. The renaming increased the percentage of cases in which patients were informed of the diagnosis from 36.7% to 69.7% in three years. Eighty-six percent of psychiatrists in the Miyagi prefecture found the new term more suitable to inform patients of the diagnosis as well as to explain the modern concept of the disorder. The Japanese treatment guideline for "Togo Shitcho Sho" was developed in 2004 under the framework of the vulnerability-stress model.

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    • "This finding does not support the notion that renaming can improve the public attitudes toward people with schizophrenia. Sato (2006) Japan Editorial The national background within which the name change had occurred was first outlined and the consequences of the renaming were discussed, by providing some empirical information drown from some studies conducted in Japan after the renaming (e.g., after 7 months the old term was replaced in 78% of cases; after three years it was increased the percentage of patients who were told their diagnosis). Maruta and Iimori (2008) Japan Survey on members (n = 80) of the Section of Classification, Diagnostic Assessment and Nomenclature of the WPA Forty-five per cent of respondents acknowledged that 'schizophrenia' is an inappropriate term for describing the disorder and 50% agreed with the notion that the term has a stigmatizing effect. "
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    ABSTRACT: The term schizophrenia is increasingly contested by researchers, clinicians, patients and families. Mental health users and professionals around the world have started calling for a change of the name, seeing it as stigmatizing and harmful. This paper reviews the literature published so far on the issue of renaming schizophrenia, carefully weighing the pros and cons of the proposed changes. Forty seven papers have been published so far, encompassing editorials, research papers, commentaries to editorials, letters, forum papers and narrative reviews. The advantages of renaming schizophrenia far outweigh the disadvantages. It would reduce stigma and benefit communication between clinicians, patients and families. The most conservative option for renaming schizophrenia would be the use of eponyms since they are neutral and avoid adverse connotations. Renaming schizophrenia is not only a matter of semantics, but also an attempt to change the stigma carried by the present name. Nevertheless, a change will not be useful unless accompanied by parallel changes in legislation, services and the education of professionals and the public. Copyright © 2015 Elsevier B.V. All rights reserved.
    Full-text · Article · Jan 2015 · Schizophrenia Research
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    • "The diagnosis of the mental illness " psychosis " or even " schizophrenia " may stigmatize the concerned person, e.g., it may put a strain on the atmosphere in the family—and even may lead to a self-fulfilling prophecy in the sense of a disturbed mental development of the person involved. (In connection with the potential of psychiatric diagnoses to stigmatize their bearers it should be mentioned that in 2002 the Japanese Society of Psychiatry and Neurology substituted the term schizophrenia ( " split-brain disorder " ) with the neutral term " integration disorder, " in order to avoid a negative stigmatizing effect with the result of lowering the threshold for the contact of concerned persons with professionals (Sato, 2006 "

    Full-text · Article · Nov 2013 · Frontiers in Psychology
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    • "Indeed, the Japanese Society of Psychiatry and Neurology changed in 2002 the diagnostic label of “Seishin Bunretsu Byo” (“mind-split-disease”, equivalent to schizophrenia) for “Togo Shitcho Sho” (integration disorder). Increased acceptability by psychiatrists and higher rates of informing the patients and families were reported after the introduction of the new term [9]. Using an Implicit Attitudinal Test, Takahashi and colleagues explored the automatic associations between the old and new schizophrenia labels and negative stereotypes (in this case, violence). "
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    ABSTRACT: The diagnosis of schizophrenia is increasingly contested by researchers, clinicians, patients and family members. Preeminent researchers proposed its replacement with the salience syndrome concept, arguing for increased validity and less stigmatizing potential. This is the first study exploring the effects on stigma of this nosological proposal. TWO STUDIES WERE CONDUCTED: one with 161 undergraduate students regarding their stigmatizing attitudes linked to the label of schizophrenia or salience syndrome, the other involved in-depth qualitative interviews with 19 participants treated in a first episode psychosis program. The interviews explored the subjective validity, acceptability and effects on stigma of a diagnosis of schizophrenia or salience syndrome. Overall, no significant differences were found between labels in study 1. For study 2, the majority of participants preferred a diagnosis of salience syndrome, considering it less stigmatizing mostly because of its novelty and the concealing potential of the new diagnostic entity, though many found it hard to relate to and somewhat difficult to understand. Our results suggest that the label change does not impact the stigmatizing potential for individuals who are not familiar with mental illness - they appear to base their attitudes on descriptions rather than the label alone. For those suffering from mental illness, a name change for schizophrenia to "salience syndrome" might offer only a temporary relief from stigma. Claims of de-stigmatizing effects should be grounded in sound scientific models of stigma and ideally in empirical data.
    Full-text · Article · Feb 2013 · PLoS ONE
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