Taiwanese Journal of Psychiatry

: 2020  |  Volume : 34  |  Issue : 3  |  Page : 146-

Did patients with schizophrenia exist in ancient Japan?

Edmund S Higgins 
 Department of Psychiatry and Family Medicine, Medical University of South Carolina, Charleston, South Carolina, USA

Correspondence Address:
Edmund S Higgins
208 Scott Street, Mt. Pleasant, South Carolina 29464

How to cite this article:
Higgins ES. Did patients with schizophrenia exist in ancient Japan?.Taiwan J Psychiatry 2020;34:146-146

How to cite this URL:
Higgins ES. Did patients with schizophrenia exist in ancient Japan?. Taiwan J Psychiatry [serial online] 2020 [cited 2022 Dec 1 ];34:146-146
Available from: http://www.e-tjp.org/text.asp?2020/34/3/146/296466

Full Text

The article written by Naotaka Shinfuku published in the Taiwanese Journal of Psychiatry nicely describes the long history of care for the mentally ill in Japan, and focused on the large number of patients that have been kept in Japanese psychiatric hospitals[1]. He noted that during the past 40 years, between 80% and 60% of these patients have been diagnosed with schizophrenia. Shinfuku also briefly discussed Japanese mental health care that dated back to the 7th century. However, the diagnoses of the early patients were not mentioned. This is relevant because there is some speculation that schizophrenia is a modern plague.

Evanset al. reviewed ancient Greek and Roman literature and reported that while other neuro-psychiatric disorders were represented (e.g., mania, melancholia, alcoholism, and epilepsy) “there were no individuals with schizophrenia”[2]. We reviewed the work of a 15th century Islamic physician and find descriptions of migraine headaches, epilepsy, melancholy and forgetfulness, but no mention of a condition that resembles schizophrenia[3].

Torrey put it clearly when he wrote, “the more one peruses these ancient sources, however, the more striking it becomes that nobody clearly described a case of schizophrenia with the initial break in late adolescence or early adulthood, the constellation of symptoms and the chronic course”[4]. Torrey and Miller does not say that schizophrenia never existed in the ancient times, but rather that there has been a marked increase in the frequency since the 17th century, noting a sevenfold increase of the illness between the mid-eighteenth century and the mid-twentieth century[5].

While we are unable to find clear cases of schizophrenia in Western literature, to my knowledge, no one has addressed this issue in historical Japanese literature, or any Asian literature. It would advance our understanding of this question if someone would review the ancient Japanese medical literature and look for the presence or absence of a condition that we would recognize as schizophrenia. I would be pleased to assist in any way that would be helpful.

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 Conflicts of Interest

The author declares no potential conflicts of interest in writing this letter.


1Shinfuku N: A history of mental health care in Japan: international perspectives. Taiwan J Psychiatry 2019; 33: 179-91.
2EvansK, McGrathJ, MilnsR: Searching for schizophrenia in ancient Greek and Roman literature: a systematic review. Acta Psychiatr Scand 2003; 107: 323-30.
3HigginsES, KoseS: Absence of schizophrenia in a 15th-century Islamic Medical Textbook. Am J Psychiatry 2007; 167: 1120.
4Torrey EF: Schizophrenia and Civilization. New York: Jason Aronson, 1980.
5Torrey EF, Miller J: The Invisible Plague: The Rise of Mental Illness from 1750 to the Present. New Brunswick, New Jersey: Rutgers University Press, 2001.