Quote:Stigma attached to individuals with schizophrenia may be derived from its diag nostic label. Two forms of a questionnaire were distributed to 189 Japanese university students. Each questionnaire contains case vignettes of schizophrenia and major depression. In one form, the students were told at the close of each vignette the diagnostic label assigned to that case (the label group) whereas in another form, they were not done so (the control group). The students were also asked to rate negative image of the case in four items each. The label group was significantly higher than the control group in three of the four negative image items for the vignette of schizophrenia. They did not differ in any of the negative image items for the vignette of depression. This suggests that the label of schizophrenia (the Japanese translation Seishin-bunretsu-byou) has stigmatizing effect. We discussed these findings in the light of the implications of a relabeling, and argued for a change of name.

Quote:The ideographic Chinese writing system (in use in Asian countries that account for about a quarter of the world's population) directly expresses the meaning of schizophrenia as "the disease of disorganized mind." The term directly challenges a deeply ingrained concept of personal autonomy, and this is stigmatizing. Japanese psychiatrists are thus reluctant to tell their patients that they are suffering from schizophrenia, and, as a result, no more than 20 percent of sufferers actually do know about their diagnosis. Because taking medication is based on informed consent and the exercise of the patient's autonomy, such lack of information has important negative effects. It is unlikely that this problem can be resolved by education or information alone, and it may well be the case that in cultures using ideographs, the illness will need to be renamed. This article suggests some alternatives.

Quote: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.

Quote:The old term for schizophrenia, "Seishin-Bunretsu-Byo" (Mind-Split Disease), has been replaced by "Togo-Shitcho-Sho" (Integration Disorder) in Japan. Stigma research requiring individuals to report personal beliefs is useful but is subject to social desirability bias. Using the Implicit Association Test, a measurement designed to minimize this bias, we assessed the impact of this renaming on the stereotype of schizophrenia held by a younger generation. The old term was strongly associated with "criminal", and this association became significantly weaker with the new term. The strategy of renaming holds considerable promise for tempering negative bias toward this disorder in Japan.

yudantaiteki Wrote:There's a tradition in Japan of doctors not telling their patients what their condition is; I don't know if this is still done, but it used to be common for the doctors to only tell the family, and then leave it up to the family to tell the patient (or not).

nest0r Wrote:A Japanese film called Welcome to the Quiet Room deals a bit with this topic, it's an interesting film.

yudantaiteki Wrote:There's a tradition in Japan of doctors not telling their patients what their condition is; I don't know if this is still done, but it used to be common for the doctors to only tell the family, and then leave it up to the family to tell the patient (or not).

IceCream Wrote:wow, that's pretty unbeleivable from a western perpective eh?

do you happen to know why they do this? i mean, like, what are the social / cultural factors that drive that kind of decision making? i find it a little bit incomprehensible...