Renaming schizophrenia: a Japanese perspective, 2006

ABSTRACT
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A survey carried out seven months after renaming in all prefectures of Japan found that the old term had been replaced by the new one in about 78% of cases.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.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472254/

 

What Is Sensory Integration Disorder? Sensory Integration Disorder (SID) or, as it is often called, Sensory Processing Disorder (SPD), is a neurological disorder that results from the brain's inability to integrate certain information received from the body's sensory systems.

 

Fascinating to think that so few patients were informed of the diagnosis, and that such a change in % informed happened just based on name change etc (which must surely mean it wasn't only down to how ill a patient was etc)

Is not informing people of their diagnoses something specific to eg Japan or common everywhere and just not mentioned?

 

I have found the following too, which is from 2014 and is interesting because it notes how these changes happened in other Asian countries following this (but how eg European has been slower to follow, despite it seems patients perhaps wanting such an update): Name Change for Schizophrenia | Schizophrenia Bulletin | Oxford Academic (oup.com)


Towards the end of this paper is the following:

"Changing the names of diseases and accompanying this by a reformulation of concepts of disease may thus be a way to reduce the stigmatization that the currently used diagnostic labels seem to facilitate and perpetuate. The changes that have been introduced in China, Hong Kong, Japan, Korea, and Singapore are a major social experiment, which will produce data that should be assembled and studied. If the changes that have been introduced do reduce or revert stigmatization, as the preliminary findings seem to indicate, a new avenue of fighting stigma will be opened. It will then be useful to proceed to similar reforms and reconceptualization of other terms used in psychiatry—in other countries of Asia and elsewhere—because that could make the life of patients and families better and the image of psychiatry more positive. Eventually this might also lead to a more general exploration of stigmatizing terms still included in the International Classification of Diseases and to the increase of attention to the use of words that might hurt in medicine."


"Stigma related to mental illness is undoubtedly the main obstacle to the improvement of mental health care. It is attached to the disorders, their names, people who are seen as being mentally ill, services which are developed to help them, and families of people with mental disorder. Stigma is related to ignorance about mental illness—providing more information and knowledge can help in the reduction of stigmatization and its consequences. Diagnoses used in psychiatry are heavily loaded with stigma and changing the name of the mental disorder provides an opportunity to say that we have learned a great deal about the disorder and that therefore it is time to also change its name. It is clear that the change of the name alone is not enough: it must be seen and experienced as part of a change of the health system, which is necessary not only to better protect human rights of the mentally ill but also because new knowledge opened new vistas and new avenues of dealing with mental illness.

The change of the name of schizophrenia in Japan went hand in hand with an effort to present an update of the concept of schizophrenia—its origin, pathogenesis, course, and methods of treatment. The first results of the change were most encouraging—seen in the relationship of patients and doctors. "

 

I'm not sure the 'Integration disorder' this is translated to is 'sensory integration disorder'. The closest article I've come to describing what it might be in these terms is: Is Schizophrenia a Type of Neurodivergence? | Psychology Today United Kingdom

and I say with caveats that this is just an opinion/discussion piece not definitional - but at least is perhaps useful in pulling apart the 'integration' bit that might be meant in this vs the sensory of eg neurodivergence

 

This is a bit like renaming disability to ability-deficit. Written in Kanji, Bunretsu (分裂) and Togo (統合) are the exact opposite. Probably done to reduce the stigma attached to schizophrenia more than anything else.

 

There is evidence that stigma-related attitudes toward people with mental health and mental illness remain relatively high in Japan.

Japan still has one of the highest suicide rates among high-income OECD countries.

Cultural attitudes towards suicide in Japan have been described as "tolerant" and sometimes even honorable. I watched a program years ago where a women psychiatrist travelled to Canada so that she could die in Yellowknife forest. There is a place called Aokigahara and sometimes referred to as the most popular site for suicide in Japan.