Kako Yuki, Okubo Ryo, Shimizu Yusuke, Mitsui Nobuyuki, Tanaka Teruaki, Kusumi Ichiro
Seishin Shinkeigaku Zasshi. 2014;116(10):813-24.
Over 10 years have passed since the Japanese term for "schizophrenia" was changed from "seishin-bunretsu-byo" to "togo-shiccho-sho" in 2002. An awareness survey targeting doctors suggested that notification of the diagnosis has been encouraged since the Japanese name for schizophrenia was changed. However, no heuristic surveys targeting patients themselves have clarified an increased notification rate, and no multicenter studies of the notification rates have been conducted in recent years. This study targeted schizophrenia patients and their attending physicians to investigate the status of notification of the diagnosis at five medical facilities in Hokkaido, Japan. Questionnaires were distributed to the attending physicians of a total of 869 patients; in addition, the patients themselves filled out questionnaires. Questionnaires were collected from 858 physicians, and valid responses were recovered from 529 patients. This study investigated the status of notification of the diagnosis and compared the attributes of patients who were notified (notified group) with those of patients who were not notified (un-notified group). The results of the survey of attending physicians regarding notification of the diagnosis of schizophrenia indicated that a total of 65.0% patients had been notified, with 63.1% of patients being notified that they had "togo-shiccho-sho" and 2.0% of patients being notified that they had "seishin-bunretsu-byo." Physicians were unsure whether patients had been notified in 18.4% of cases. On excluding these cases, the results indicated that over 79.6% of patients had been notified that they had either "togo-shiccho-sho" or "seishin-bunretsu-byo." The patient questionnaire results regarding patients' awareness of the name of their disease showed that 55.2% answered "togo-shiccho-sho," 3.2% answered "seishin-bunretsu-byo," 9.5% answered the name of another disease, 17.4% answered that they did not know the name of their disease, and 14.7% answered that they knew the name of their disease but did not include any specific details. On excluding these unspecified answers, 68.5% of patients were aware that they had either "togo-shiccho-sho" or "seishin-bunretsu-byo." Comparison of the notified with the un-notified group revealed that the period from treatment initiation in the notified group was shorter than that in the un-notified group, and the mean age of the notified group at the time of the survey was lower than that of the un-notified group. Furthermore, significantly more patients started treatment before 2002, when the Japanese name for schizophrenia was changed, in the un-notified group. The results of this study suggested that the change of the Japanese name of schizophrenia to "togo-shiccho-sho" and historical background resulted in more active notification of the diagnosis.
自2002年日语中“精神分裂症”的术语从“せいしんぶんれつ病(seishin-bunretsu-byo)”改为“統合失調症(togo-shiccho-sho)”以来,已经过去了10多年。一项针对医生的认知调查表明,自精神分裂症的日语名称更改后,诊断告知得到了鼓励。然而,针对患者自身的启发式调查并未明确诊断告知率的提高,近年来也没有进行过关于诊断告知率的多中心研究。本研究以精神分裂症患者及其主治医生为对象,调查了日本北海道5家医疗机构的诊断告知情况。向总共869名患者的主治医生发放了问卷;此外,患者本人也填写了问卷。从858名医生那里回收了问卷,从529名患者那里获得了有效回复。本研究调查了诊断告知情况,并比较了已被告知诊断的患者(告知组)和未被告知诊断的患者(未告知组)的特征。关于精神分裂症诊断告知的主治医生调查结果显示,共有65.0%的患者被告知诊断,其中63.1%的患者被告知患有“統合失調症(togo-shiccho-sho)”,2.0%的患者被告知患有“せいしんぶんれつ病(seishin-bunretsu-byo)”。在18.4%的病例中,医生不确定患者是否已被告知。排除这些病例后,结果表明超过79.6%的患者被告知患有“統合失調症(togo-shiccho-sho)”或“せいしんぶんれつ病(seishin-bunretsu-byo)”。患者问卷中关于患者对自身疾病名称认知的结果显示,55.2%的患者回答“統合失調症(togo-shiccho-sho)”,3.2%的患者回答“せいしんぶんれつ病(seishin-bunretsu-byo)”,9.5%的患者回答了其他疾病的名称,17.4%的患者回答不知道自己疾病的名称,14.7%的患者回答知道自己疾病的名称但未提及任何具体细节。排除这些未明确的回答后,68.5%的患者知道自己患有“統合失調症(togo-shiccho-sho)”或“せいしんぶんれつ病(seishin-bunretsu-byo)”。告知组与未告知组的比较显示,告知组从开始治疗到现在的时间比未告知组短,调查时告知组的平均年龄低于未告知组。此外,在未告知组中,在2002年精神分裂症日语名称更改之前开始治疗的患者明显更多。本研究结果表明,精神分裂症日语名称改为“統合失調症(togo-shiccho-sho)”及其历史背景导致了更积极的诊断告知。