Schizophrenia in society and culture

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Schizophrenia (sz) presents a complex array of societal, economic, and health challenges. Social problems associated with the disorder include unemployment, poverty, and homelessness, particularly affecting vulnerable populations. Disability statistics reveal sz as a significant contributor to global disability-adjusted life years, ranking high among disabling conditions. The economic burden of sz is substantial, with costs encompassing healthcare expenses and societal impacts like reduced productivity and law enforcement expenditures. Conversely, the pharmaceutical industry has seen a notable market related to sz treatment.

Mortality studies highlight elevated suicide rates and physical health concerns among individuals with sz, alongside social judgment issues complicating their recovery. The disorder's portrayal in culture and media, exemplified by figures like John Forbes Nash and Vaslav Nijinsky, adds layers to public perception. Despite ongoing debates about its presentation and treatment, sz remains a multifaceted phenomenon with far-reaching implications for individuals and society.

Society[change | change source]

Schizophrenia poses significant societal challenges, including unemployment, poverty and homelessness[1] among affected individuals. The prevalence of the disorder fluctuates based on its local definition.[2] Advancing research on mental health is crucial in gaining insights into these challenges and devising more effective strategies to support individuals in need.[3]

Disability[change | change source]

Schizophrenia is responsible for considerable portion of global disability, accounting for roughly 1% of worldwide disability-adjusted life years.[4] Active hallucinations, a hallmark symptom of sz, rank as the third-most-disabling aspects of the condition, underscoring the profound impact of the disorder on affected individuals' functionality and quality of life.[5]

Financial aspects[change | change source]

Main articles: Market and Schizophrenia in society and culture § People with schizophrenia

The economic impact of schizophrenia is substantial, with the disorder costing an estimated $62.7 billion in the United States alone in 2002.[6] These costs encompass direct expenses related to hospitalization, medication, and long-term care, as well as indirect costs such as reduced workplace productivity, unemployment, and expenses incurred by law enforcement. Additionally, antipsychotic medications, commonly prescribed for sz, are utilized for various other conditions, contributing to a significant number of prescriptions. In the European Union, approximately 16.5 million individuals received daily antipsychotic prescriptions in 2018,[7] with notable increases observed in England between 1998 and 2010.[8]

Pharmaceutical market[change | change source]

The market size for SZ drugs was valued as $9,000,000,000 in 2021. [9] Some firms offering drugs in this market include:

  • Acadia Pharmaceuticals
  • BioXcel Therapeutics
  • Boehringer Ingelheim
  • Eli Lilly
  • Gedeon Richter
  • Intra-Cellular Therapies
  • Johnson & Johnson
  • Karuna Therapeutics
  • Lundbeck
  • Luye Pharma
  • MedinCell
  • Minerva Neurosciences
  • Neurocrine Biosciences
  • Novartis
  • Otsuka
  • Reviva Pharmaceuticals
  • Sunovion Pharmaceuticals
  • Teva [10]

Mortality[change | change source]

External[change | change source]

A study of 160 people admitted to hospital with sz during the period January 1997 to 31 December 2012 who had committed homicide in England and Wales found that 94% had a history of alcohol and/or illegal drug consumption and/or were not in receipt of their prescribed medication. In a study of the actus reus of homicide of the years 1997–2003 in England and Wales, diagnosed schizophrenics were more likely to use an object with a sharpened edge, including knives. Homicides were mostly against family members or a spouse in their homes. [11][12][13][14][15][16]

Internal[change | change source]

Individuals with schizophrenia face elevated risks of suicide compared to the general population, along with a higher prevalence of physical health issues.[17][18] In 2015, approximately 16,900 deaths were attributed to sz-related causes.[19] A comprehensive study involving over 4 million individuals diagnosed with sz revealed that suicide, injury-poisoning, and undetermined non-natural cause were the most common reasons for death, followed by pneumonia.[20] Notably, the use of antipsychotic medication was identified as the primary cause for pneumonia diagnosis in one study. These findings underscore the urgent need for effective interventions to address both the mental and physical health challenges faced by individuals with sz.

Social judgement issues[change | change source]

Bad social judgment has been identified as a major obstacle in the recovery of schizophrenics.[21]

The word "schizophrenia" is used in reporting as a metaphor in newspapers worldwide.[22][23][24]

Symptoms amongst non-patient groups[change | change source]

Auditory hallucinationsTemplate:Broken anchor have been shown to extend to mental health nurses[25] and non-patients.[26][27]

Tobacco[change | change source]

Sz and smoking have shown a strong association in studies worldwide.[28][29] Those individuals who smoke tend to smoke heavily and to smoke cigarettes with a high nicotine content.[30]

Culture[change | change source]

Art[change | change source]

People with schizophrenia[change | change source]

The sister of Dr Eugen Bleuler was admitted to a Zurich hospital with a catatonic illness. Dr Bleuler would later be the director of the same hospital where he diagnosed his sister with sz. [31][32][33]

Vaslav Nijinsky (born 1889 [34] died 1950) [35] was a dancer; his parents were also dancers. [36] He was known from about 1913 by the sobriquets [37] as "the God of dance" [38][37][39] and "God's clown". [36] During or sometime after March 1919 Dr Bleuler diagnosed Nijinsky "a confused schizophrenic with mild manic excitement" which meant she didn't need to go to a hospital.[35]

Camille Claudel, diagnosed retrospectively, was a sculptor, and during 1913 became a patient. [40]

Eduard Einstein, one of the children of Dr. Albert Einstein, was diagnosed with sz and lived his life in a hospital. [41][42][43] Eduard was diagnosed by a Dr. Bleuler sometime during the 1930's. [42]

John Forbes Nash
John Forbes Nash

John Forbes Nash was diagnosed with sz in 1959. John was a mathematician from the United States. He was given the Nobel Prize in Economic Sciences in 1994 for "equilibria in the theory of non-cooperative games".[44]



Alternate realities: psychoanalytic and religious[change | change source]

Some researchers believe that in certain unique situations, the personal experience or appearance of psychosisTemplate:Broken anchor is evidence of genius. [45]

The autoplastic nature of the psychotic's derangement enters unaltered ... into a work of art"

— K.R. Eissler [46]

Similarities are thought to exist of the structure of how sz is diagnosed with experiences of mysticism. [47]

Presentation in biography and cinema[change | change source]

A book, "A Beautiful Mind", and then a movie by the same name was made about the life of John Forbes Nash.[44]

The movie “The Soloist” tells the story of Nathaniel Ayers, a prodigious musician who dropped out of the Juilliard School in New York City after the symptoms of sz began. He later became homeless in Los Angeles, California, in the notorious Skid Row section.

Other words[change | change source]

People sometimes use the words schiz or schizo as abbreviations. [48][49]

References[change | change source]

  1. ↑ Charlson FJ, Ferrari AJ, Santomauro DF, et al. (17 October 2018). "Global Epidemiology and Burden of Schizophrenia: Findings From the Global Burden of Disease Study 2016". Schizophrenia Bulletin. 44 (6): 1195–1203. doi:10.1093/schbul/sby058. PMC 6192504. PMID 29762765. people with schizophrenia are more likely to be unemployed, homeless, living in poverty
  2. ↑ van Os J, Kapur S (August 2009). "Schizophrenia" (PDF). Lancet. 374 (9690): 635–45. doi:10.1016/S0140-6736(09)60995-8. PMID 19700006. S2CID 208792724. Archived from the original (PDF) on 2013-06-23. Retrieved 2013-04-15.{{cite journal}}: CS1 maint: date and year (link)
  3. ↑ "The Curse of Schizophrenia". Wall Street Journal. 1999-09-20. ISSN 0099-9660. Retrieved 2023-12-16.
  4. ↑ Picchioni MM, Murray RM (July 2007). "Schizophrenia". BMJ. 335 (7610): 91–5. doi:10.1136/bmj.39227.616447.BE. PMC 1914490. PMID 17626963.
  5. ↑ Ustun TB; Rehm J; Chatterji S; Saxena S; Trotter R; Room R; Bickenbach J; and the WHO/NIH Joint Project CAR Study Group (1999). "Multiple-informant ranking of the disabling effects of different health conditions in 14 countries". The Lancet. 354 (9173): 111–15. doi:10.1016/S0140-6736(98)07507-2. PMID 10408486. S2CID 26454481.
  6. ↑ Wu EQ (2005). "The economic burden of schizophrenia in the United States in 2002". J Clin Psychiatry. 66 (9): 1122–9. doi:10.4088/jcp.v66n0906. PMID 16187769.
  7. ↑ Guidance Antipsychotic medicines Published 25 August 2005 Medicines & Healthcare products Regulatory Agency Guidance UK Government
  8. ↑ Stephen Ilyas and Joanna Moncrieff "Results TABLE 1" In: Trends in prescriptions and costs of drugs for mental disorders in England, 1998–2010 The British Journal of Psychiatry, 200(5), 393-398. doi:10.1192/bjp.bp.111.104257
  9. ↑ Schizophrenia Market Size and Trend Report including Epidemiology and Pipeline Analysis, Competitor Assessment, Unmet Needs, Clinical Trial Strategies and Forecast, 2021-2031 Published: September 21, 2022 GlobalData Plc: John Carpenter House, John Carpenter Street, London
  10. ↑ Key Players GlobalData Plc: John Carpenter House, John Carpenter Street, London
  11. ↑ Alison Baird, Roger T. Webb, Isabelle M. Hunt, Louis Appleby and Jenny Shaw Homicide by men diagnosed with schizophrenia: national case–control study BJPsych Open, 6(6), E143. doi:10.1192/bjo.2020.129
  12. ↑ Cathryn Rodway, Cathryn Rodway, Nicola Swinson, Alison Roscoe, Alison Roscoe, Kirsten Windfuhr, Kirsten Windfuhr, Louis Appleby, Jenny Shaw Methods of homicide in England and Wales: a comparison by diagnostic group The Journal of Forensic Psychiatry & Psychology, 20:2, 286-305, DOI: 10.1080/14789940802360870
  13. ↑ GLOSSARY Actus reus definition LexisNexis
  14. ↑ Mens rea and actus reus The Incorporated Council of Law Reporting for England & Wales
  15. ↑ OVERVIEW actus reus non facit reum nisi mens sit rea Oxford University Press
  16. ↑ Valeria Abreu Minero, Edward Barker, and Rachael Bedford "4.1. Schizophrenia/delusional disorder and sharp instruments" in Method of homicide and severe mental illness: A systematic review Aggress Violent Behav. 2017 Nov;37:52-62. https://doi.org/10.1016/j.avb.2017.09.007. Epub 2017 Sep 28. PMID: 31354381; PMCID: PMC6660311.
  17. ↑ van Os J, Kapur S (August 2009). "Schizophrenia" (PDF). Lancet. 374 (9690): 635–645. doi:10.1016/S0140-6736(09)60995-8. PMID 19700006. S2CID 208792724. Archived from the original (PDF) on 23 June 2013. Retrieved 23 December 2011.
  18. ↑ Hor K, Taylor M (November 2010). "Suicide and schizophrenia: a systematic review of rates and risk factors". Journal of Psychopharmacology. 24 (4 Suppl): 81–90. doi:10.1177/1359786810385490. PMC 2951591. PMID 20923923.
  19. ↑ Wang H, Naghavi M, Allen C, et al. (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". The Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  20. ↑ Christoph U Correll, Marco Solmi, Giovanni Croatto, Lynne Kolton Schneider, S Christy Rohani-Montez, Leanne Fairley, Nathalie Smith, István Bitter, Philip Gorwood, Heidi Taipale, Jari Tiihonen Mortality in people with schizophrenia: a systematic review and meta-analysis of relative risk and aggravating or attenuating factors World Psychiatry. 2022 Jun;21(2):248-271. doi: 10.1002/wps.20994. [Discussion: ("RR=9.76-8.42") & "RR=7.00" c.f. (i.e. 6, 5, 4) (4.0 ≠ 3.00 - 3.999 rec.) "RR=3 to 4", "RR=2 to 3", "RR=1.33 to 1.96"]
  21. ↑ Maj, Mario and Sartorius N. (15 September 1999). Schizophrenia. Chichester: Wiley. p. 292. ISBN 978-0-471-99906-5.
  22. ↑ Christina Athanasopoulou, Maritta Välimäki 'Schizophrenia' as a metaphor in greek newspaper websites Stud Health Technol Inform. 2014:202:275-8.
  23. ↑ Arun K Chopra, Gillian A Doody Schizophrenia, an illness and a metaphor: analysis of the use of the term 'schizophrenia' in the UK national newspapers J R Soc Med. 2007 Sep;100(9):423-6. doi: 10.1177/014107680710000919. PMID: 17766915; PMCID: PMC1963407.
  24. ↑ Kenneth Duckworth, M.D., John H. Halpern, M.D., Russell K. Schutt, Ph.D., Christopher Gillespie, M.A. Use of Schizophrenia as a Metaphor in U.S. Newspapers Psychiatric Services Volume 54 Issue 10 October 2003 Pages 1402-1404 https://doi.org/10.1176/appi.ps.54.10.1402
  25. ↑ Millham RN BA MSc, Mental Health Nurse, Easton BSc MA CPsychol ASBPSS, Clinical Psychologist/Senior Lecturer Prevalence of auditory hallucinations in nurses in mental health Psychiatric and Mental Health Nursing Volume5, Issue 2 April 1998
  26. ↑ C. Choong BMBS, BMedSci, M. D. Hunter MBChB, MRCPsych & P. W. R. Woodruff MBBS, PhD, MRCP, FRCPsych Auditory hallucinations in those populations that do not suffer from schizophrenia Curr Psychiatry Rep 9, 206–212 (2007). https://doi.org/10.1007/s11920-007-0020-z
  27. ↑ HONIG, ADRIAAN M.D., Ph.D., MRCPsych.1; ROMME, MARIUS A. J. M.D., Ph.D.2; ENSINK, BERNARDINE J. M.Sc., Ph.D.2; ESCHER, SANDRA D. M. A. C.2; PENNINGS, MONIQUE H. A. M.A.2; DEVRIES, MARTEN W. M.D., Ph.D.Auditory Hallucinations: A Comparison between Patients and Nonpatients The Journal of Nervous & Mental Disease 186(10):p 646-651, October 1998.
  28. ↑ De Leon J, Diaz FJ (2005). "A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors". Schizophrenia Research. 76 (2–3): 135–57. doi:10.1016/j.schres.2005.02.010. PMID 15949648. S2CID 32975940.
  29. ↑ Keltner NL, Grant JS (2006). "Smoke, Smoke, Smoke That Cigarette". Perspectives in Psychiatric Care. 42 (4): 256–261. doi:10.1111/j.1744-6163.2006.00085.x. PMID 17107571.
  30. ↑ American Psychiatric Association. Task Force on DSM-IV. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. American Psychiatric Pub. ISBN 9780890420256. p. 304
  31. ↑ Mark L. Ruffalo M.S.W., D.Psa. A Lesson from Bleuler on Schizophrenia Psychology Today 28 October 2019
  32. ↑ Jessica Resnick 2017-04-06 Paul Eugen Bleuler (1857–1939) Arizona State University
  33. ↑ Tina Joos-Bleuler Being a Member of the Bleuler Family Schizophr Bull. 2011 Nov; 37(6): doi: 10.1093/schbul/sbr135 PMCID: PMC3196944 PMID: 22013083
  34. ↑ Nijinsky Living with Schizophrenia
  35. ↑ 35.0 35.1 Emilio Fernandez-Egea One hundred years ago: Nijinsky and the origins of schizophrenia, 25 October 2018: Brain, Volume 142, Issue 1, January 2019, Pages 220–226, https://doi.org/10.1093/brain/awy262
  36. ↑ 36.0 36.1 Vaslav Nijinski Choreographer Opéra national de Paris
  37. ↑ 37.0 37.1 Carol Diethe Historical Dictionary of Nietzscheanism Historical Dictionaries of Religions, Philosophies, and Movements, No. 75 Second Edition p.208 The Scarecrow Press, Inc. 2007
  38. ↑ Emilio Fernandez-Egea One hundred years ago: Nijinsky and the origins of schizophrenia, 25 October 2018: Brain, Volume 142, Issue 1, January 2019, Pages 220–226, https://doi.org/10.1093/brain/awy262 "The God of Dance in Paris" - "Psychosis in his own words": "a classic self-portrait of the symptoms of schizophrenia - Delusions of influence "I realised that God did this on purpose so that I would correct my notebook. God writes all this for me and men’s’" - grandiose delusions with omnipotence"...
  39. ↑ PIPPA CRAWFORD Nijinsky on Nijinsky: the Decline and Fall of the Ballet Russes Archived 2023-11-02 at the Wayback Machine Pushkin House 3 March 2020
  40. ↑ J Oules [Camille Claudel. Her psychiatric case history] https://pubmed.ncbi.nlm.nih.gov/8279734/ Ann Med Psychol (Paris). 1993 Aug-Sep;151(7):485-98.
  41. ↑ Clare Fitzgerald Albert Einstein forgotten son eduard the Vintage News
  42. ↑ 42.0 42.1 Paul Halpern April 21, 1936 Medium
  43. ↑ Mileva Einstein-Maric Biography.com
  44. ↑ 44.0 44.1 John F. Nash Jr. Facts Nobel Prize
  45. ↑ John E. Gedo Nietzsche and the Psychology of Genius American Imago Vol. 35, No. 1/2, MYTH, CREATIVITY, PSYCHOANALYSIS: Essays in Honor of Harry Slochower (SPRING-SUMMER, 1978), pp. 77-91 (15 pages) Published By: The Johns Hopkins University Press
  46. ↑ K.R. Eissler in: Anne Wilson Wangh Vaslav Nijinsky: Genius and Schizophrenic American Imago Vol. 35, No. 3 (FALL, 1978), pp. 221-237 (21 pages) Published By: The Johns Hopkins University Press
  47. ↑ Josef Parnas, Mads Gram Henriksen Mysticism and schizophrenia: A phenomenological exploration of the structure of consciousness in the schizophrenia spectrum disorders Consciousness and Cognition Volume 43, July 2016, Pages 75-88
  48. ↑ comments reddit
  49. ↑ Caleb Cain Millenarian Dreams of the Schizo-scene Journal EXIT-Deutschland.

Bibliography[change | change source]

Killaspy H (September 2014). "Contemporary mental health rehabilitation". East Asian Archives of Psychiatry. 24 (3): 89–94. PMID 25316799.

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