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重新命名精神分裂症:为何、如何以及接下来做什么?

Renaming schizophrenia: why, how, and what next?

作者信息

Mesholam-Gately Raquelle I, Nagendra Arundati, Keshavan Matcheri

机构信息

Department of Psychiatry, Beth Israel Deaconess Medical Center.

Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.

出版信息

Curr Opin Psychiatry. 2025 May 1;38(3):147-153. doi: 10.1097/YCO.0000000000001002. Epub 2025 Mar 11.

Abstract

PURPOSE OF REVIEW

The debate over renaming schizophrenia has gained international momentum, driven by concerns about stigma and scientific accuracy. This review examines the arguments for and against renaming schizophrenia, highlighting research data from the US and international efforts.

RECENT FINDINGS

Proponents argue that the current term perpetuates stigma, is scientifically outdated, and that stakeholders, including those with lived experience, favor a name change. Opponents, however, caution that renaming might not reduce stigma and could complicate access to care. Stigma associated with schizophrenia leads to significant discrimination in healthcare, employment, and social interactions. Moreover, the term inaccurately suggests a 'split' in the brain, contributing to public misconceptions. Survey data from various countries reveal substantial support for renaming, with some evidence suggesting that new terms can reduce stigma and improve treatment engagement. Historical precedents, such as the renaming of multiple personality disorder to dissociative identity disorder, show that such changes can occur without disrupting care.

SUMMARY

The review concludes that while renaming schizophrenia could align the term with contemporary science and reduce stigma, a systematic, consensus-building approach involving diverse stakeholders is essential. Future steps should focus on finding an appropriate name that reflects the illness's core aspects and ensures optimal care.

摘要

综述目的

出于对污名化和科学准确性的担忧,关于精神分裂症更名的争论在国际上愈演愈烈。本综述审视了支持和反对精神分裂症更名的论据,重点介绍了来自美国的研究数据以及国际上的相关努力。

最新发现

支持者认为,当前的术语延续了污名化,在科学上已过时,而且包括有实际患病经历者在内的利益相关者都赞成更名。然而,反对者警告称,更名可能不会减少污名化,还可能使获得医疗服务变得复杂。与精神分裂症相关的污名化在医疗保健、就业和社会交往中导致了严重的歧视。此外,该术语错误地暗示了大脑的“分裂”,加剧了公众的误解。来自不同国家的调查数据显示,对更名有大量支持,一些证据表明新术语可以减少污名化并提高治疗参与度。历史先例,如将多重人格障碍更名为分离性身份障碍,表明这样的改变可以在不扰乱医疗服务的情况下发生。

总结

综述得出结论,虽然精神分裂症更名可以使该术语与当代科学接轨并减少污名化,但采取一种涉及不同利益相关者的系统的、建立共识的方法至关重要。未来的步骤应侧重于找到一个合适的名称,以反映该疾病的核心方面并确保最佳治疗。

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