Schizophrenia as social discourse: how do people use their diagnosis for social action?

摘要

'Schizophrenia' can do things other than diagnose or stigmatize those so defined in that it can serve various forms of social action. Two hundred and fifty-eight randomly selected patients with an experience of schizophrenia and their relatives participated in the study of schizophrenia as social discourse. They used the diagnosis for political struggle and social leverage in such diverse forms as demonstration of the meaning of 'a schizophrenic', discursive intervention for ideological invitation, reclaiming personal worth (revalorization), solidarity with fellow patients and economic compensation. Despite the inherent value of the diagnosis in helping them get the right treatment, participants saw devaluing meaning in various designations for schizophrenia and, given choice, preferred certain formulations of the diagnosis over others in relation to their social discourse. To be effective, treatment models, service delivery and communication with patients must allow, interpret and incorporate their first person accounts (discourse) as a feature of their individuality and uniqueness in the therapeutic process. This is likely to increase their sense of wellbeing, empowerment and cooperation with the treatment.