Outcomes from previous name changes

The increased interest in changing the name of schizophrenia in recent years has supposedly been influenced by the movement in Japan which was the first country that introduced a new name for the disorder (Maruta and Matsumoto, 2017 ). In 2011, South Korea followed this development and replaced ‘mind-split disease’ with ‘attunement disorder’ (Lasalvia et al ., 2015 ). In Taiwan ‘mind-split disease’ was replaced by ‘dysregulation of thought and perception’ in 2012. Hong-Kong introduced a new name (‘dysfunction of thought and perception’) along with the old term ‘splitting of mind’ which is still in use (Maruta and Matsumoto, 2017 ).

There are studies that confirm the positive effect and the reduction of stigma after introduction of these name changes in Japan and South Korea. It is reported that the new names evoke less prejudice, improve communication between clinicians and patients and promote social integration (Lasalvia et al ., 2015 ; Lasalvia, 2018 ). But it was also found that the new term was not easy to understand for the public without further explanation. In addition, the media continued using the established name of the disorder (Lasalvia et al ., 2015 ).

However, there is little empirical evidence on the effects of renaming schizophrenia on stigmatisation (Ellison et al ., 2015 ). This is especially true for outcomes that affect patients and family members. Most studies either address professionals or samples of laypersons. There are very few studies that address patients and family members, those who are affected the most by stigma and discrimination. A systematic review by Yamaguchi et al . ( 2017 ) found only one study that addressed attitudes of family members of schizophrenia patients. According to the authors, this study by Nishimura et al . ( 2005 ) showed that the name change results in a less severe image of symptoms and less negative attitudes. However, there were no differences in perceptions of social adjustment problems or knowledge about the disorder (Yamaguchi et al ., 2017 ).

Conclusion

Renaming an established and widely used term is a lengthy and complex process and its long-term outcomes are not fully known yet. There are studies that report favourable outcomes of the name changes, like, for example, improved communication between patients and clinicians and less stigmatizing attitudes towards people with schizophrenia (Yamaguchi et al ., 2017 ). But there are also studies that found no significant differences between different names (Tranulis et al ., 2013 ). Thus, the outcomes of renaming are still inconclusive (Yamaguchi et al ., 2017 ). In addition, the majority of studies focus on professionals and not on those who are affected the most: patients and families. More studies including these groups need to be conducted in order to get a broader picture on the implications of a name change. Besides the limited evidence base, the aspect of cultural diversity needs to be taken into account. Even if a name change of ‘mind-split disease’ was successful in Asian countries, this does not necessarily imply that a change of schizophrenia would result in a similar outcome improvement. Changing ‘schizophrenia’ would be a whole new endeavour. And so far, the scientific community has not come to an agreement on any alternative name for schizophrenia. Finding a new name which all relevant groups agree on is an enormous challenge that still has to be faced. Probably, this will not be solved until the underlying causes of the disorder will be discovered so that schizophrenia can be re-conceptualised (Lieberman and First, 2007 ). For now, the current term and concept have proven their reliability, clinical utility and validity.

Changing names does not necessarily resolve the problem of stigma as the conflicting evidence shows (Yamaguchi et al ., 2017 ). Stigmatised properties could be carried over to a new name and a possibly positive effect would be of temporary nature (Lasalvia, 2018 ). What really needs to be changed is the way that mental illness is seen by the public. It needs to be ensured that all members of society are treated respectfully and have equal rights. This is the kind of activism that is effective for all discriminated groups, regardless of their naming (Tracy, 2017 ). Misconceptions and stereotypes need to be dissolved by education, positive advocacy and by setting good examples.

Acknowledgement

Footnotes

References