Renaming "Schizophrenia" is the subject of discussion in a new Forum in the journal Psychological Medicine. Two authors propose a new name "Psychosis Susceptibility Syndrome" and experts comment.

The authors of the article, Aadt Klijn and Bill George, from the Dutch Association of and for People with a Psychotic Vulnerability (Anoiksis), reflect what several commentators have been saying for a long time.

The aim of having the new name - Psychosis Susceptibility Syndrome - is partly to better reflect the signs and symptoms of this mental illness, and to eradicate the stigma, prejudices and misleading significance surrounding the term "schizophrenia" and "schizophrenic".

Schizophrenia - a word with negative undertones

The term 'schizophrenia' is loaded with negative connotations. Even today, when the average man or woman hears the term schizophrenia, it brings up images of dangerous and unreliable 'lunatics'.

The term affects people both ways, it carries with it a general stigma, and causes self-stigma in those who have been diagnosed. A person with schizophrenia is stamped by society with a negative hallmark. As the patient has been brought up to perceive 'schizophrenics' negatively, they take the negative blueprint to themselves, which in turn leads to a negative self-image.

Not only does the term incite prejudice, it is a source of misunderstanding. Most people think schizophrenia refers to a Jekel and Hyde split personality, which is not the case - therefore the term is a misnomer. There are split-personality disorders, but they have nothing to do with what we currently call schizophrenia.

WHO (World Health Organization) was approached recently with a request to adopt the new term, which is currently not recognized anywhere. The Japanese Society of Psychiatry and Neurology renamed Seishin Bunretsu Byo (split mind) to Togo-Shitcho Sho (integration dysregulation syndrome).

Why the name Psychosis Susceptibility Syndrome (PSS)?

Psychosis Susceptibility Syndrome
Anoiksis chose the term Psychosis Susceptibility Syndrome (PSS) for the following reasons:
  • Psychosis - because of the unreality of delusions and hallucinations.
  • Susceptibility - patients are not necessarily psychotic all the time (but it is latent).
  • Syndrome - according to Medilexicon's medical dictionary, a syndrome is "The aggregate of symptoms and signs associated with any morbid process, together constituting the picture of the disease." Syndrome includes the negative and cognitive symptoms also linked to the disease. Negative symptoms might include lack of feelings and energy, while cognitive symptoms could be concentration and memory problems, or a reduced capacity for problem-solving, for example.
The majority of health care professionals, patients and their loved ones agree that the name should be changed. However, most people believe that what really needs changing is the public perception of schizophrenia.

Dr Alison Brabban, Honorary Clinical Senior Lecturer in Clinical Psychology in the Mental Health Research Centre, Durham University, England, and colleagues wrote:

"There is no doubt that for many, the diagnosis of schizophrenia can be as debilitating as the associated symptoms. The word 'schizophrenia' appears to do more harm than good, more frequently communicating prejudice and misinformation than fact and hope.

It is indisputable that the stigma surrounding the term schizophrenia can in itself lead to misery for many with the diagnosis.

Therefore, any label that removes some of these disadvantages would be a welcome change."

Professor Richard P. Bentall, Lecturer at the Institute of Psychology, Health and Society, University of Liverpool, England, said "Schizophrenia has been a contested label for many years not only because it is associated with stigma, but also because it fails to achieve any of the purposes for which it was originally designed. Rebranding schizophrenia solves none of these problems. By replacing one ill-fitting label with another, we do nothing to advance psychiatric research or to develop better treatment plans for our patients.

It is not hard to locate some of these causes. Without a doubt, one is the media's treatment of schizophrenia, which consistently over-emphasizes the risk of dangerous behaviour by patients, conveying the impression that people with psychosis are responsible for an epidemic of interpersonal violence. The reality is, of course, quite different. Whereas there is an increased risk of violence associated with psychosis, most of this is attributable to co-morbid substance abuse and most psychiatric patients pose absolutely no risk to their neighbours.

The problem has become not whether to replace schizophrenia, but what to replace it with. Simple re-labelling will do nothing to address the many scientific and clinical limitations of the categorical approach to diagnosis. Nor is it likely to address the problem of stigma, which arises out of background assumptions about the nature of severe mental illness. To persuade the general public to be more accepting of people with mental illness, we must persuade them that psychosis arises, in part, understandably from adverse life experiences (while of course acknowledging that genetic factors must play some role), that it does not necessarily lead to violence, and that recovery is possible."
A study started off by a team of experts in Sydney, Australia, reported in the journal Schizophrenia Bulletin that homicides of strangers by individuals diagnosed with schizophrenia are extremely rare events.

Written by Christian Nordqvist