Schizophrenia on Turkish Twitter: an exploratory study investigating misuse, stigmatization and trivialization

This study aims to investigate use and misuse of the word 'schizophrenia' and its derivatives to assess the prevalence of stigmatizing and trivializing attitudes and the meanings attributed to the condition on Turkish Twitter.

Using R programming language, we collected Turkish Twitter posts containing the terms used for schizophrenia in Turkish through Twitter's Search API over a 47-day period between July and June 2019. After removing retweets, we randomly sampled 3000 tweets and manually categorized them in three dimensions: use type (metaphorical/non-metaphorical), topic and attitude. Qualitative analysis on representative tweets were performed and word frequencies were calculated.

In total 44,266 tweets were collected and after removing retweets, 24,529 tweets were obtained. Overwhelming majority of the tweets (91.7%) used the terms metaphorically and the majority displayed stigmatizing (68.3%) and trivializing (23%) attitudes. Politics was the most common topic (58.2%) followed by everyday/social chatter (28.5%). Only a small number of tweets were part of awareness campaigns (0.2%) or displayed a supportive attitude (0.8%). Terms were often used metaphorically in a stigmatizing manner as personal or political insults, while in everyday/social contexts, they were used in a trivializing manner to label eccentricity, oddness, overthinking and suspiciousness. Popularity and reach metrics show that these tweets were extensively retweeted, liked and reached millions of users.

This is the first study investigating attitudes towards schizophrenia on Turkish Twitter. Significantly higher rates of stigmatizing attitudes demonstrate the urgent need for public health and social awareness campaigns targeting stigma surrounding schizophrenia in Turkey.