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Aker S, Kahve AC. What do psychiatrists think about renaming schizophrenia in Turkey? Schizophr Res 2022; 248:8-13. [PMID: 35907348 DOI: 10.1016/j.schres.2022.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/30/2022] [Accepted: 07/10/2022] [Indexed: 10/16/2022]
Abstract
In this study, it was aimed to evaluate the opinions of psychiatrists in Turkey on whether to change the name of schizophrenia in order to reduce stigma. This cross-sectional survey was conducted with psychiatrists (resident in psychiatry, specialist, and lecturer) in Turkey. An online survey was created via the Google Forms public web address. Online questionnaires were delivered through Google Forms by emailing and messaging on WhatsApp, Telegram, Google and Yahoo groups and asking them to pass the questionnaire to other possible participants in their network. The study was performed between June 20, 2021 and July 10, 2021. 460 psychiatrists participated in the study. Forty-five-point 2 % of psychiatrists think that the name of schizophrenia should be renamed to reduce stigma. Forty-two-point 8 % of those who support the name change state that this change should be done as soon as possible. While 64.1 % of psychiatrists stated that naming the disease with another (new) name instead of schizophrenia could increase the hopes of patients and their relatives for recovery, 12.6 % stated that renaming would not cause any positive or negative changes. There is no statistical difference between psychiatrists who have a relative diagnosed with schizophrenia and psychiatrists who do not, in terms of thinking that the name of schizophrenia should be renamed to reduce stigma. In order to remove the stigma on schizophrenia, many interventions are required in social, cultural, economic and political fields. Renaming schizophrenia may be a good start for interventions.
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Affiliation(s)
- Servet Aker
- Department of Medical Education, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey.
| | - Aybeniz Civan Kahve
- Department of Psychiatry, Ankara City Hospital, University of Health Sciences, Ankara, Bilkent, Turkey
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Galderisi S, Giordano GM. We are not ready to abandon the current schizophrenia construct, but should be prepared to do so. Schizophr Res 2022; 242:30-34. [PMID: 34924240 DOI: 10.1016/j.schres.2021.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022]
Abstract
The current schizophrenia construct as delineated in the latest editions of the DSM and the ICD has some strengths, but also many weaknesses. It improved the reliability of the diagnosis, made communication among clinicians, users and families less ambiguous, is useful for education and training, and for reimbursement and insurance purposes. However, many serious weaknesses should be considered. The term "Schizophrenia" does not recognize the heterogeneity of the disorder and might nourish the belief that schizophrenia represents a unitary disease. In addition, there is no agreement on the existence and nature of a "core aspect" of the disorder. Stable dimensions, in particular negative symptoms and cognitive impairment, which are key determinants of functioning, are not de facto regarded as core aspects. Finally, the construct is associated to the notion of a poor outcome, to a high level of stigma and has acquired a derogatory connotation. We are not ready but should be prepared to abandon the current schizophrenia construct. Clinicians and researchers should be encouraged to complement the ICD/DSM diagnosis with an in-depth characterization of the individual clinical picture, along with other variables, such as family history, comorbidities, vulnerability factors and personal trajectory. The "Primary Psychoses" construct, together with improved cross-sectional and longitudinal phenotypes from representative population and patient cohorts, and the availability of artificial intelligence methods, could lead to a new and more precise taxonomy of psychotic disorders, and increase the probability of identifying meaningful biomarkers to improve prevention, diagnosis, prognosis, and treatment for people suffering from psychotic disorders.
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Nasrallah HA. To change the label of schizophrenia, first revise the construct. Schizophr Res 2021; 238:201-202. [PMID: 34800757 DOI: 10.1016/j.schres.2021.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 11/07/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Henry A Nasrallah
- Neurology and Neuroscience, University of Cincinnati College of Medicine, United States of America.
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Mesholam-Gately RI, Varca N, Spitzer C, Parrish EM, Hogan V, Behnke SH, Larson L, Rosa-Baez C, Schwirian N, Stromeyer C, Williams MJ, Saks ER, Keshavan MS. Are we ready for a name change for schizophrenia? A survey of multiple stakeholders. Schizophr Res 2021; 238:152-160. [PMID: 34688117 DOI: 10.1016/j.schres.2021.08.034] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
About one in 100 people worldwide are diagnosed with schizophrenia. Many people advocate for a name change for the condition, pointing to the stigma and discrimination associated with the term "schizophrenia", as well as to how the name poorly characterizes features of the illness. The purpose of this project was to collect opinions from a broad, diverse sample of stakeholders about possible name changes for schizophrenia. The project represented a partnership between researchers, clinicians, and those with lived experience with psychosis. The group developed a survey to assess opinions about the need for change in the name schizophrenia as well as potential alternate names. We accumulated 1190 responses from a broad array of community stakeholders, including those with lived experience of mental illness, family members, clinicians, researchers, government officials, and the general public. Findings indicated that the majority of respondents (74.1%) favored a name change for schizophrenia. Most (71.4%) found the name stigmatizing. Of the proposed alternate names, those with the most support included "Altered Perception Syndrome", "Psychosis Spectrum Syndrome", and "Neuro-Emotional Integration Disorder". Survey findings provide strong support for renaming schizophrenia. Most expressed hope that a name change will reduce stigma and discrimination.
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Affiliation(s)
- Raquelle I Mesholam-Gately
- Department of Psychiatry, Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 75 Fenwood Rd., Boston, MA 02115, USA.
| | - Nicole Varca
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 75 Fenwood Rd., Boston, MA 02115, USA
| | - Courtney Spitzer
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 75 Fenwood Rd., Boston, MA 02115, USA
| | - Emma M Parrish
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 75 Fenwood Rd., Boston, MA 02115, USA; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA 92182, USA
| | - Victoria Hogan
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 75 Fenwood Rd., Boston, MA 02115, USA
| | - Stephen H Behnke
- Department of Psychiatry, Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 75 Fenwood Rd., Boston, MA 02115, USA
| | - Linda Larson
- Consumer Advisory Board, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 75 Fenwood Rd., Boston, MA 02115, USA
| | - Christian Rosa-Baez
- Consumer Advisory Board, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 75 Fenwood Rd., Boston, MA 02115, USA
| | - Nate Schwirian
- Consumer Advisory Board, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 75 Fenwood Rd., Boston, MA 02115, USA
| | - Charles Stromeyer
- Consumer Advisory Board, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 75 Fenwood Rd., Boston, MA 02115, USA
| | - Michael J Williams
- Consumer Advisory Board, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 75 Fenwood Rd., Boston, MA 02115, USA
| | - Elyn R Saks
- Gould School of Law, University of Southern California, 699 Exposition Boulevard, Los Angeles, CA 90089, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, 75 Fenwood Rd., Boston, MA 02115, USA
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Lasalvia A, Vita A, Bellomo A, Tusconi M, Favaretto G, Bonetto C, Zanalda E, Mencacci C, Carpiniello B. Renaming schizophrenia? A survey among psychiatrists, mental health service users and family members in Italy. Schizophr Res 2021; 228:502-509. [PMID: 32593734 DOI: 10.1016/j.schres.2020.03.047] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/17/2020] [Accepted: 03/21/2020] [Indexed: 01/10/2023]
Abstract
This survey explores how psychiatrists, service users and family members in Italy perceive the term schizophrenia and if they consider a name change a useful option in order to overcome the stigma attached to it. Opinions on the term schizophrenia were collected by a self-rated questionnaire used in previous international surveys. Questionnaires were delivered members of the Italian Psychiatric Association. Survey of mental health users was conducted among members of the main users' association of the Veneto region; survey of family members was conducted among one of the most representative Italian family association. Overall, 350 psychiatrists, 71 mental health users and 110 family members filled in the questionnaires. Considering the whole sample, 41.5% found the term inappropriate, 67.6% stigmatizing and 72.3% advocated a name change. Among psychiatrists 57% reported that schizophrenia was inappropriate, 70% considered the term stigmatizing and 71% was in favor of a name change. Similarly, 56% of service users and 71% of family members found schizophrenia a stigmatizing term and, respectively, 75% and 77% advocated a name change. Conflicting results were found on possible alterative terms: psychiatrists proposed a wide range of possible options, most of which referred to the term 'psychosis' (53%), whereas users and family members preferred terms referring to the broad category of 'mental health suffering'. Overall, most of respondents in the three stakeholders' groups agree that schizophrenia should be renamed to reduce the stigma attached to it; the main challenge, however, is the lack of consensus on the best alternative term to use.
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Affiliation(s)
- Antonio Lasalvia
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy; UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Department of Mental Health and Addiction Services, ASST Spedali Civili, Brescia, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Massimo Tusconi
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Gerardo Favaretto
- Department of Mental Health, Local Health Authority ULSS 2 Marca Trevigiana, Treviso, Italy
| | - Chiara Bonetto
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Enrico Zanalda
- Integrated Mental Health Department ASL TO 3 and AOU San Luigi Gonzaga, Torino, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
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Meadows R, Hine C, Suddaby E. Conversational agents and the making of mental health recovery. Digit Health 2020; 6:2055207620966170. [PMID: 33282335 PMCID: PMC7683843 DOI: 10.1177/2055207620966170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 09/22/2020] [Indexed: 11/26/2022] Open
Abstract
Background Artificial intelligence (AI) is said to be “transforming mental health”. AI-based technologies and technique are now considered to have uses in almost every domain of mental health care: including decision-making, assessment and healthcare management. What remains underexplored is whether/how mental health recovery is situated within these discussions and practices. Method Taking conversational agents as our point of departure, we explore the ways official online materials explain and make sense of chatbots, their imagined functionality and value for (potential) users. We focus on three chatbots for mental health: Woebot, Wysa and Tess. Findings “Recovery” is largely missing as an overt focus across materials. However, analysis does reveal themes that speak to the struggles over practice, expertise and evidence that the concept of recovery articulates. We discuss these under the headings “troubled clinical responsibility”, “extended virtue of (technological) self-care” and “altered ontologies and psychopathologies of time”. Conclusions Ultimately, we argue that alongside more traditional forms of recovery, chatbots may be shaped by, and shaping, an increasingly individualised form of a “personal recovery imperative”.
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Affiliation(s)
- Robert Meadows
- Department of Sociology, University of Surrey, Guildford, Surrey, UK
| | - Christine Hine
- Department of Sociology, University of Surrey, Guildford, Surrey, UK
| | - Eleanor Suddaby
- Department of Sociology, University of Surrey, Guildford, Surrey, UK
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Valle R. Schizophrenia in ICD-11: Comparison of ICD-10 and DSM-5. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020; 13:95-104. [PMID: 32336596 DOI: 10.1016/j.rpsm.2020.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 11/15/2019] [Accepted: 01/22/2020] [Indexed: 10/24/2022]
Abstract
The conceptualization of schizophrenia has changed from its initial conception in the 19th century to the recent publication of the ICD-11. The changes incorporated in this latest version were made based on the evaluation of the current ICD, the available scientific evidence, and the consensus reached by its developers. In this paper we describe the conceptualization changes (diagnostic criteria and specifiers) of ICD-11 schizophrenia with respect to those of ICD-10 and DSM-5. The changes found are discussed based on the scientific literature published in Medline, Scopus and Scielo until July 2019 and the information on the Wordl Health Organization and American Psychiatric Association websites. Given that the diagnosis of schizophrenia is based on the diagnostic criteria of the diagnostic classification systems, it is important to know the changes made in its conceptualization and the evidence supporting such modifications.
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Affiliation(s)
- Rubén Valle
- Centro de Investigación en Epidemiología Clínica y Medicina Basada en Evidencias, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Perú; DEIDAE de Adultos y Adultos Mayores, Instituto Nacional de Salud Mental «Honorio Delgado-Hideyo Noguchi», Lima, Perú.
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Colizzi M, Lasalvia A, Ruggeri M. Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? Int J Ment Health Syst 2020; 14:23. [PMID: 32226481 PMCID: PMC7092613 DOI: 10.1186/s13033-020-00356-9] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 03/16/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Similar to other health care sectors, mental health has moved towards the secondary prevention, with the effort to detect and treat mental disorders as early as possible. However, converging evidence sheds new light on the potential of primary preventive and promotion strategies for mental health of young people. We aimed to reappraise such evidence. METHODS We reviewed the current state of knowledge on delivering promotion and preventive interventions addressing youth mental health. RESULTS Half of all mental disorders start by 14 years and are usually preceded by non-specific psychosocial disturbances potentially evolving in any major mental disorder and accounting for 45% of the global burden of disease across the 0-25 age span. While some action has been taken to promote the implementation of services dedicated to young people, mental health needs during this critical period are still largely unmet. This urges redesigning preventive strategies in a youth-focused multidisciplinary and trans-diagnostic framework which might early modify possible psychopathological trajectories. CONCLUSIONS Evidence suggests that it would be unrealistic to consider promotion and prevention in mental health responsibility of mental health professionals alone. Integrated and multidisciplinary services are needed to increase the range of possible interventions and limit the risk of poor long-term outcome, with also potential benefits in terms of healthcare system costs. However, mental health professionals have the scientific, ethical, and moral responsibility to indicate the direction to all social, political, and other health care bodies involved in the process of meeting mental health needs during youth years.
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Affiliation(s)
- Marco Colizzi
- 1Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
- 2Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF UK
| | - Antonio Lasalvia
- 1Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - Mirella Ruggeri
- 1Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
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