Disadvantage of Classification over Labeling

When we classify and name similar symptoms and make a classification by focusing on their common points and similarities, we call this system diagnosis. Diagnoses are a product of classification. The classification system that has survived to this day is DSM. It is a handbook containing the diagnostic criteria for all psychiatric disorders defined today.

The classification system has both advantages and disadvantages. If we briefly talk about its advantages, it creates a common language for experts, so that all experts can understand the same thing when bipolar disorder is mentioned, instead of explaining it one by one. There is no waste of time and the most effective treatment method can be chosen. Depending on the pattern of abnormal behavior encountered, we can predict its course and origins. However, in addition to these advantages, it can also cause some disadvantages. For example, the diagnosed person may be labeled and excluded by the society, and since some symptoms may be in different clusters, this may lead to misdiagnosis.

    The most difficult disadvantage for the diagnosed person is being labeled and, as a result, not being accepted by the people around him/her. Or we can say that it is experiencing exclusion. I would like to detail this situation through a case I heard from my family. M.Ç, who is now 38 years old, lives with his family in a village. He was tortured during his military service, witnessed many events that affected him psychologically, and when he returned, they realized that he did not behave the same way as before. Thereupon, his family takes him to a psychiatrist and the doctor diagnoses him with schizophrenia. In particular, he has a lot of delusions and constantly conveys to people his strong beliefs such as "they are after me, they want to kill me, the state will not leave me alone." Although his family tries to follow him to use his medications, he has difficulties in using them regularly. Afterwards, his family realizes that many of his friends who used to spend time with him now change their ways when they see M.Ç. People in the village also started to spread some rumors such as "he lost his mental health, he went crazy, he is attacking people, let's keep our children away". That is, apart from his family (who received the necessary information from experts after the diagnosis), no one stayed with him and everyone es looks at him like a crazy monster. It is also known that he had great difficulties in finding a job and that no one would accept him because it would harm his customers. It is possible that they may defend incorrect views by approaching them unconsciously and without knowledge. Accordingly, when the effects of factors such as age, gender, education, race, social class, culture, profession and previous acquaintance with the disease on attitudes towards mental illnesses are examined, the general opinion is that older people, people with low education and low socioeconomic levels are less tolerant of people with mental illnesses. (Arkar, 1991). So, we can say that if the person had experienced these experiences in an urban environment, there was a possibility that he would not have been ostracized so much.

    At the same time, the position of patients in society, their acceptance or exclusion is directly related to society's view of schizophrenia. For example, if it is widely thought that these patients are aggressive and can harm those around them, they will probably live an isolated life from society. As seen in the case I gave as an example, people around M.Ç. think that they need to be protected from him due to his delusions. However, individuals diagnosed with schizophrenia only try to protect themselves (because they have delusions that they will harm them) and do not want to cause harm on purpose. Özmen, Taşkın, Özmen et al. (2007), the biggest reason why individuals diagnosed with schizophrenia are stigmatized and excluded is that they are perceived as dangerous and unpredictable people. Especially the feeling of fear and anger is an important variable in terms of social distance and exclusion. It has been observed that the results are similar in almost all cultures.

    Another factor that increases the tendency for schizophrenic patients to be stigmatized and excluded is the media, especially television. As everyone acknowledges, media coverage of mental illnesses clearly paints negative images. Crisp et al. (2000), It has been shown that the belief in the society that "those with mental illnesses become aggressive" is mostly due to news containing aggression and violence in the media. The media's misinformation and harmful information about mental illnesses negatively affects the public's attitude towards patients and increases prejudices and stigmatization in society.

    Chung et al. (2009) investigated the causal relationship between demographic factors, intensity of depressive symptoms, perceived stigma, perception of superiority, social support, and quality of life in 237 depressed patients. While they found that higher levels of stigma were associated with more severe depressive symptoms, lower social support, and lower levels of superiority perception, they did not find a direct relationship between stigma and quality of life. Based on this, schizophrenia patients are more likely to show depressive symptoms in environments where labeling is high. However, there is no information about how the person in the case felt due to these labels.

   Finally, Angermeyer et al. (1999), the most appropriate attempt to increase the social acceptance of these people and reduce the tendency to stigmatize them is to inform the society that the patients are not more dangerous than other people. Reducing the prejudices in society that patients are dangerous and aggressive people will primarily lead to a decrease in fear, which will reduce the isolation of patients.

 

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