Comparison of diagnostic names of mental illnesses in medical documents before and after the adoption of a new Japanese translation of ‘schizophrenia’

Abstract

Aim: The name of a disease entered in medical documents often differs from the true diagnosis in psychiatric practice. We examined the effects of different translations of ‘schizophrenia’ into Japanese on the usage of disease names in documents. Methods: We conducted a retrospective survey of the names of diseases used in the medical documents of 250 outpatients with schizophrenia or depression. These patients had attended our department of psychiatry between 1998 and 2000. We also investigated the names of the diseases of 226 outpatients who had first visited our department between 2003 and 2007. We defined the diagnosis (based on ICD‐10) as the ‘ICD‐10 disease name’ and the name of the disease written in medical documents as the ‘disease name in documents’. We classified the documents that were used to apply for national psychiatric care and welfare services as ‘official documents’ and those submitted to others as ‘private documents’. Results: Prior to 2000, the term ‘seishin‐bunretsu‐byo’ (‘split‐mind disease’; old translation of ‘schizophrenia’) was used in 72.3% of official documents and 3.6% of private documents. In 2003 and later, the term ‘togo‐shitcho‐sho’ (‘integration disorder’; new translation of ‘schizophrenia’) was used in 98.0% of official documents and 21.7% of private documents. Conclusion: The use of ‘togo‐shitcho‐sho’ in official documents has become established. On the other hand, terms such as ‘nervous breakdown’ and ‘depressive state’ are still commonly used in private documents after the adoption of the new Japanese translation of schizophrenia.

Should the label "schizophrenia" be abandoned?

“…In August 2002, the Japanese Society of Psychiatry and Neurology (JSPN) proposed the old term seishin-bunretsu-byo ("mind-split-disease") be replaced with togo-shitcho-sho ("integration dysregulation syndrome"). This was officially recognized by the Japanese Ministry of Health and Welfare in 2005 and currently its use has become established in medical documents (Takahashi et al, 2011). The new term referred to the vulnerability-stress model, and stressed that the disorder is treatable, with recovery possible if a combination of advanced pharmacotherapy and psychosocial intervention was provided (Sato, 2006).…”

Review of mental‐health‐related stigma in Japan

“…In terms of Japanese activities aimed at overcoming such stigma, the National Federation of Families with Mentally Ill in Japan requested that the psychiatric society change the name of the illness, which was a translation of the German name schizophrenie (literally meaning split mind) . The new name was adopted in 2002 and became commonly used in official documents . In addition, to improve mental health literacy, facilities such as health centers have conducted educational programs about mental health for local communities …”

“…Not surprisingly, there is still a harmful mental‐health‐related stigma in Japan. For example, in a large‐scale cross‐sectional survey, only 5% of the general public believed that people with mental illness could recover fully from their illness through professional help …”

“…6 The new name was adopted in 2002 and became commonly used in official documents. 14 In addition, to improve mental health literacy, facilities such as health centers have conducted educational programs about mental health for local communities. 11 Despite the development of such approaches to address mental-health-related stigma, it remains a serious problem that adversely affects the lives of people with mental health problems in many countries.…”

Erasing Stigma Is Much More Than Changing Words

“…This is a relatively new endeavor, and research on its impact is still evolving. Much of the research is from Japan, where results indicate that psychiatrists and other mental health providers soon learned new labels (5). A survey of Japanese psychiatrists suggested that new terms facilitated education about illness and psychosocial interventions, although the survey results were reported as part of a larger review and thus the report lacked specifics about methodology (2).…”