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Korean Journal of Schizophrenia Research 2008;11(2):65-70.
통합실조증:일본에서의 정신분열병의 병명개정 과정과 효과
Mitsumoto Sato, MD, PhD
Abstract
In order to reduce the stigma, the Japanese Society of Psychiatry and Neurology (JSPN) changed the old term of schizophrenia, “Seishin Bunretsu Byo” (mind-split disease) into new term of “Togo Shitcho Sho” (integration disorder) in 2002. It was 64 years after translating schizophrenia into “Seishin Bunretsu Byo”. The change was triggered by the request of a patients’ family group to JSPN in 1993. The main reasons were hopeless nuance of the old term denying their personality, the deep-rooted negative image of schizophrenia, in part related to the long-term inhumane treatment of most people with this disorder in the past, and the recent advances in psychiatry. The renaming was associated with the shift from the Kraepelian concept of the disease (hereditary but unknown etiology, unable to cure, poor outcome leading to deterioration of personality) to vulnerability-stress model of the disorder (disintegration of neurotransmitter systems mainly dopamine, treatable, expectable to Vrecover and cure). The old term has been replaced by the new one in about 78% in most prefectures of Japan 7 months after renaming, and finally replaced legislatively in 2006. 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 (psycho-education). The Japanese treatment guideline for “Togo Shitcho Sho” was developed in 2004, and revised in 2008 under the framework of the vulnerability-stress-coping model of the disorder. The renaming of the old stigmatized term into new term with current concept of the disorder has provided hope of recovery to the patients with schizophrenia and promote a modern advanced treatment under realistic optimism. (Korean J Schizophr Res 2008;11:65-70)
Key Words: Integration disorder,Schizophrenia,Vulnerability stress model.
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