Renaming Schizophrenia

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The name “Schizophrenia” is the subject of a new Forum in the journal Psychological Medicine. An article written by Bill George and Aadt Klijn, Foreign Affairs co-coordinators for Anoiksis (the Dutch association of and for people with a psychotic vulnerability), has been reflected on by various commentators.

Anoiksis has introduced a new name for the disease schizophrenia: psychosis susceptibility syndrome (PSS) with the aim that together with the old name, its attached prejudices, misleading significance and stigma can be thrown overboard.

Schizophrenia is a term loaded with negative connotations, since it still conveys an image of people with schizophrenia as all being unreliable, dangerous ‘lunatics’. The term consequently lends itself to stigma and self-stigma. Society stamps persons with schizophrenia with a negative hallmark; people diagnosed with schizophrenia then take the negative blueprint to themselves and this gives rise to a negative self-image. Not only does the term call up prejudices, it maintains misunderstandings, because schizophrenia means split personality and is therefore a misnomer. A split personality is in fact quite another disorder and has nothing to do with what we currently call schizophrenia.

Recently the World Health Organisation has been approached with a request to recognise the new name – currently the name PSS is not recognised either nationally or internationally.

Anoiksis has chosen the name Psychosis Susceptibility Syndrome (PSS) – the reasoning is as follows:

  • Psychosis: because of the unreality of hallucinations and delusions.
  • Susceptibility: because patients are not necessarily continually psychotic (but it is latent).
  • Syndrome: because this word includes the negative and cognitive symptoms also associated with the disease. Negative symptoms include lack of feelings and energy while cognitive symptoms may be problems with concentration and memory or a reduced capacity for problem-solving for example.

Full commentaries have been provided by several people, who generally agree with the idea of changing the name, but argue that the biggest change will come from changing the public perception of schizophrenia.

Dr Brabban and colleagues comment, “There is no doubt that for many, the diagnosis of schizophrenia can be as debilitating as the associated symptoms. The word ‘schizophrenia’ appears to do more harm than good, more frequently communicating prejudice and misinformation than fact and hope. It is indisputable that the stigma surrounding the term schizophrenia can in itself lead to misery for many with the diagnosis. Therefore, any label that removes some of these disadvantages would be a welcome change.”

Professor Bentall states, “Schizophrenia has been a contested label for many years not only because it is associated with stigma, but also because it fails to achieve any of the purposes for which it was originally designed. Rebranding schizophrenia solves none of these problems. By replacing one ill-fitting label with another, we do nothing to advance psychiatric research or to develop better treatment plans for our patients.

“It is not hard to locate some of these causes [of stigma]. Without a doubt, one is the media’s treatment of schizophrenia, which consistently over-emphasizes the risk of dangerous behaviour by patients, conveying the impression that people with psychosis are responsible for an epidemic of interpersonal violence. The reality is, of course, quite different. Whereas there is an increased risk of violence associated with psychosis, most of this is attributable to co-morbid substance abuse and most psychiatric patients pose absolutely no risk to their neighbours.

“The problem has become not whether to replace schizophrenia, but what to replace it with. Simple re-labelling will do nothing to address the many scientific and clinical limitations of the categorical approach to diagnosis. Nor is it likely to address the problem of stigma, which arises out of background assumptions about the nature of severe mental illness. To persuade the general public to be more accepting of people with mental illness, we must persuade them that psychosis arises, in part, understandably from adverse life experiences (while of course acknowledging that genetic factors must play some role), that it does not necessarily lead to violence, and that recovery is possible.”

“Forum”, can be viewed free of charge for a limited time and comprises 5 articles

View the original competition poster here.

View the winning name poster (English language) here.

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One Response to Renaming Schizophrenia

  1. Rosemary Jones says:

    Using the word psychosis is for the professionals only and therefore should not be used at all, since psychotic, like schizophrenic – broken minded, it also is negatively loaded.

    Basically, psychiatric and neurological labeling should reflect the condition, and people on antipsychotic medication – dopamine antagonist medication – have in common is excess dopamine production which, though designed for survival, sends their more recently acquired cognitive and linguistic functions haywire.

    Medical science should list the causes of stress which in turn causes the excess dopamine production, and so they may be properly dealt with. That way people will no longer be maintained in a state of ill health and on medications which are shortening their lives and, in many instances, preventing any real quality of life.

    The list should include disease and inflammation, (which is why so called ‘schiz’ symptoms respond to antibiotics), physical damage to the cells, interrupted arterial flow resulting in oxygen and other element deficits, and functioning overuse because of bereavement, anger or street drug usage, and without the necessary oxygen and other essential elements to back up such use.

    The term covering all the situations which involve dopamine antagonist medications, that is the antipsychotic medications, should not be ‘psychotic’ because this is not sufficiently explanatory and has too many bad connotations, but rather the HYPERDOPAMINE CONDITION.

    This, like hyperthyroidism, would have no bad connotations, and each causal category could be added after the label.

    For example – the most common cause of stress, which is also the most difficult to ascertain, and therefore largely ignored or wrongly accounted for, is MILD AND INTERMITTENT HYPOXIA AND BRAIN NUTRIENT DEFICIENCY, so anyone who has vertebral artery syndrome, that is an occlusion to one of the four main neck arteries causing an oxygen and other element deficit, would be described as suffering from an ARTERIAL OCCLUSION RELATED HYPERDOPAMINE CONDITION. Such a label would mean their diagnostic A4 would ensure they would never be treated by people who, through lack of training, were incapable of understanding what was wrong with them, including psychiatrists and mental health social workers.

    The Deputy Prime Minister has recently described the UK’s mental health provision as being like THE DARK AGES, and not so long ago, a Government Committee found many neurologists to be HEARTLESS FAILURES.

    It is time for change, not least updating all clinicians on the latest research to make up for the fact that most of their training is often as much as 30 years out of date, and also adopting a new scientifically based labeling system. This would be a huge step forward for both the neurology and psychiatric disciplines.

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