Opinion - Letters to the Editor   

On schizophrenia

Schizophrenia is a serious mental disorder that encounters the consequences of stigma. As a solution to reduce stigma, the article “Limits of the label ‘schizophrenia,’” (Oct. 10) quotes some psychiatrists’ suggestion that the term schizophrenia be replaced with another name. How we wish this were as simple. The stigma will not change by giving it a different name. One of the main sources of stigma is the belief that schizophrenia is different from other physical illnesses.

One way of fighting stigma is to educate the public that schizophrenia is like other medical illnesses. It helps little to devalue this view and to encourage ‘psychological theories’ of a doubtful evidence base. For example, there is very little evidence that psychological trauma causes schizophrenia. Though the earlier diagnostic systems had problems of reliability and validity, they have considerably improved with the emergence of the classificatory system in recent times. Schizophrenia is now considered a syndrome of multifactorial origin with several dimensions of symptoms and not a single disease entity.

The views about medication use are biased and highlight side-effects. Luckily, side-effects apply to a minority of patients as with any medical treatment. Highlighting this will indirectly lower the value of the benefits produced by medication. In a study conducted by NIMHANS recently, it was seen that disability due to schizophrenia can be brought down with inexpensive medication devoid of serious side-effects. The benefit of continuing medication and the risk of relapse with discontinuing medication have been established. Comprehensive improvement can take place only when medication is given along with psychosocial interventions.

B.N. Gangadhar,

Bangalore

C.P. Rabindranath,

Madurai

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On schizophrenia

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