University of Southampton, Southampton, UK.
Epidemiol Psychiatr Sci. 2013 Dec;22(4):297-301. doi: 10.1017/S2045796013000486. Epub 2013 Sep 10.
Names matter! Schizophrenia has negative associations which impede individual recovery and induce societal and self-stigmatization. Alternatives have been proposed and are worthy of debate; changes made in Japan have generally been considered successful. The group of 'schizophrenia and other psychoses' could be further differentiated based on the major social factors identified, i.e. drug misuse and the effects of severe childhood trauma. The use of appropriate International Classification of Diseases (ICD) coding and definitions could usefully differentiate these groups - the former is a drug-induced psychosis and the latter frequently presents as comorbid schizophrenia and borderline personality disorder (often attracting a diagnosis of schizoaffective disorder). The current established differentiation between early onset ('stress-sensitive' - 'Kraepelinian' schizophrenia) and later onset (DSM5 delusional disorder, i.e. with 'non-bizarreness' criterion removed) psychosis may also be worthy of further investigation to establish validity and reliability. Psychosocially descriptive terms have been found to be more acceptable to patients and perceived as less stigmatizing by others. Subgroups of psychosis with greater homogeneity would benefit research, clinical and therapeutic practice and public understanding, attitudes and behaviour.
名称很重要!精神分裂症带有负面联想,这会阻碍个体康复并导致社会和自我污名化。已经提出了替代方案,值得讨论;日本的变革通常被认为是成功的。“精神分裂症和其他精神病”这一组可以根据确定的主要社会因素进一步区分,即药物滥用和严重童年创伤的影响。适当使用国际疾病分类(ICD)编码和定义可以有效地区分这些群体——前者是药物引起的精神病,后者通常表现为共病精神分裂症和边缘型人格障碍(通常被诊断为分裂情感障碍)。目前在发病早期(“应激敏感型”-“克雷丕林精神分裂症”)和发病后期(DSM5 妄想障碍,即去除“非怪异”标准)之间建立的精神分裂症的区别也可能值得进一步研究,以确定其有效性和可靠性。精神上可描述的术语被发现更容易被患者接受,并且被他人认为较少污名化。具有更大同质性的精神病亚组将有益于研究、临床和治疗实践以及公众的理解、态度和行为。