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Abolish label 'schizophrenia,' psychologist says

Tuesday, October 10, 2006 | 2:58 PM ET

CBC News

The term schizophrenia should be dropped because it is not scientifically valid and is stigmatizing, a mental health expert says, renewing a debate on the best ways to fight the shame associated with the disease.

Schizophrenia is a brain disorder in which a person loses touch with reality. Symptoms include delusions, hallucinations, disturbances in thinking and withdrawal from social activity.

More than 250,000 Canadians are living with schizophrenia, which affects an estimated one per cent of the population.

"It groups together a whole range of different problems under one label," Richard Bentall, a professor of clinical psychology at the University of Manchester, told a news conference in London on Monday, the eve of World Mental Health Day.

"The assumption is that all of these people with all of these different problems have the same brain disease."

People with schizophrenia should be diagnosed and treated based on their individual psychological symptoms, rather than psychiatric categories of symptoms that may not apply, said Bentall.

Bentall's perspective runs contrary to mainstream psychiatry, said Dr. Robert Zipursky, a psychiatrist with the Centre for Addiction and Mental Health in Toronto.

Using individual psychological symptoms to diagnose the affliction is like using symptoms of fever and cough to diagnose pneumonia, Zipursky said. Many psychiatric illnesses may cause symptoms such as hallucinations and delusions but are not necessarily schizophrenia, and psychiatrists are skilled at making the determination.

The Campaign for the Abolition of the Schizophrenia Label, or CASL, also argues the term schizophrenia is associated with unpredictability, danger, inability to cope and the need for long-term treatment, said Paul Hammersley of the University of Manchester, who launched the campaign.

Reality of illness
The campaign points to Japan, which dropped the category schizophrenia in favour of "integrated disorder" in 2004. The terms dopamine dysregulation disorder, thought disorder and psychosis are other suggested replacements.

However, it may be easier to replace the term in non-English speaking societies where schizophrenia isn't ingrained in the medical system, said Zipursky.

There is research showing the value of the term schizophrenia, and no replacement word that conveys the types of problems associated with the disorder, he said.

Schizophrenia Society of Canada retaining name
The Schizophrenia Society of Canada has discussed changing its name but remains proud of the title, said the group's CEO, Mary Jardine.

"Everyone is aware that there may be negative connotations...[associated with] using the term," Jardine said Tuesday. "I think the value in the name, in the terminology, is that it expresses the reality of the illness."

Fighting the stigma requires being open about the seriousness of the disease and how it affects the brain, Jardine suggested.

"To think that the stigma will go away because we change the name is probably a little bit unrealistic," Zipursky agreed, adding a better approach is to fight the stigma of schizophrenia itself, as advocates for cancer and HIV/AIDS are doing

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