Culture & Identity

What’s in the name
of a diagnosis?
Gina Nicoll
Would a diagnosis by another name carry the same ideas?
Image By Phoebe Maharaj
Minds Matter Magazine Volume III Issue I Culture & Identity
Imagine you are meeting Hiromi, a 22-yearold
Japanese man. He has integration disorder,
which can affect his thoughts and perceptions.
Sometimes, what he experiences does
not reflect reality. But with the right help, he
can recover and lead a normal life.
What is your first impression of Hiromi? Would
you be open to being friends with him?
Would your view of him change if you knew
he actually had schizophrenia?
This thought experiment is the reality
in Japan. In 2002, the Japanese medical system
changed Seishin-Bunretsu-Byo - which
translates to “mind-split disease” - to Togo-Shitcho-Sho
or integration disorder. Mindsplit
disease is the same diagnosis as schizophrenia,
which comes from the Greek words
for “split” and “mind.”
Along with the name change, Japanese
psychiatrists created new associations for integration
disorder. It is no longer a debilitating
and hopeless disease leading to decline and
discrimination. Under a vulnerability-stress
model, they rebranded it as a disorder where
recovery is possible with the right medication
and support.
If you hear “schizophrenia” and think
of threat and aggression, you are not alone.
A 2001 study of Quebecois individuals found
that 54 per cent of respondents considered
people with schizophrenia dangerous and violent.
However, people with schizophrenia
are 14 times more likely to be victims of violence
than perpetrators of it. Reports also
indicate that 99.97 per cent of people with
schizophrenia are not convicted of serious
violence in a year.
Our public perceptions of schizophrenia
are not just wrong; they are actively
harmful. A 2014 study examined how changing
the name of schizophrenia could change
perception. The study found that treatment
outcomes for schizophrenia are poorer in
the Western world - where only one in three
people with schizophrenia recover - than in
Nairobi, Kenya, where one in two people recover.
One of the main reasons for this is said
to be the stigma associated with schizophrenia
in the Western world.
In a different survey, two-thirds of
people with schizophrenia did not pursue
treatment because of the anticipated stigma.
Another survey cited in the study found that
the majority of Western people with schizophrenia
view the discrimination that comes
from having schizophrenia more negatively
than the symptoms of the disorder itself.
In Japan, before the name of the diagnosis
changed, there were similar associations
between schizophrenia, unpredictability,
and violence. Many doctors would not
inform people of their diagnosis for fear of
inflicting stigma and discrimination, which
would affect their treatment.
Since the name change, the diagnosis
is viewed as less stigmatizing. Within two
years, 33 per cent more people were informed
of their diagnosis, and 86 per cent of
psychiatrists surveyed said the change made
it easier to tell family and friends about the
diagnosis and helped introduce education
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