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eISSN: 2379-6383

Public Health

Short Communication Volume 13 Issue 1

Rethinking Schizophrenia in the field of primary care. Analysis of the movie “A Thread of Hope” (Out of Darkness), starring Diana Ross (1994)

Manuel Torres Fernández

Institution University of Santiago de Compostela. Spain

Correspondence: Manuel Torres Fernández, Institution University of Santiago de Compostela. Spain, Enderezo personal: Lugar de Cesariños 22, Caldas de Reis, Spain, Tel (34)620416810

Received: March 05, 2024 | Published: March 21, 2024

Citation: Fernández MT. Rethinking Schizophrenia in the field of primary care. Analysis of the movie “A Thread of Hope” (Out of Darkness), starring Diana Ross (1994). MOJ Public Health. 2024;13(1):50-51. DOI: 10.15406/mojph.2024.13.00437

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Schizophrenia has traditionally been considered a serious and chronic mental illness, of a degenerative nature that ultimately leads to dementia. However, for a few decades now, malignancy's prognosis has been questioned, and we can see this eloquently in films such as A Beautiful Mind (2001), in which the mathematician John Nash recovers from his paranoid schizophrenia after thirty years of suffering from serious delusions, prominent hallucinations and intellectual disorders with the final achievement of the Nobel Prize in Economics in 1994 and in the film object of our analysis a medical student who, after 18 years of suffering from the same disease, is cured without sequelae through the administration of an experimental treatment, in this case clozapine. The purpose of our communication is to analyze the possibilities that the formulation of the General Health Law since 1986 has for the family doctor in Spain, which decreed the closure of the old asylums and the care of patients with mental health problems in their socio-familial environment and with the same rights as patients of other specialties, regarding the prevention, diagnosis and treatment of these pathologies.

Keywords: schizophrenia, delusions, hallucinations mental health, psychiatric reform


Schizophrenia is possibly the most serious mental disorder in the field of psychiatry, it is often said that its history is the history of psychiatry itself, its diagnosis is made syndromically, i.e. by identifying a set of symptoms and signs present over time, so that from the psychopathological point of view the appearance of a change in the personal and social behavior of the patient for which there is no explanation would be sufficient to identify it as suggestive of the presence of this clinical picture. The most recent research confirms the presence of neurobiological anomalies, specifically a defective functioning of dopamine, which would predispose the existence of a vulnerability to the triggering of the disease in a stressful situation. It would therefore be the conjunction of genetic and environmental factors, from a personal, family and social point of view, which would give rise to the triggering of this psychotic disorder, which is certainly a public health problem of notorious importance.1,2

On the other hand, our study focuses on the analysis of both positive and negative symptomatology observable in the film (types of delirium, hallucinations, language disorders, the risks for the patient or for other people at times of decompensation of the disease), the means of mechanical containment used, the pharmacological treatments with special relevance in the cure by clozapine after the previous rejection of two antipsychotics, and finally the assessment of the activity of family support/control with respect to the patient.


In the film starring Diana Ross, we can clearly observe the presence of delusions of persecution, reference prejudice, somatic, denial and also delusions of control, in some scenes the protagonist says that her brain has been stolen, regarding the auditory hallucinations the auditory ones are clearly shown with the voices that speak to her, and also the gustatory ones.1 On the other hand, the abandonment of the medication observed in the first scenes leads to the return of the symptoms, and the conversion of the sick woman into a danger to herself, in addition to the fact that in the middle of an acute psychotic episode she is arrested naked in the street and with agitation that leads her to involuntarily slap her mother, she also intoxicates her sister with her treatment, thus becoming a danger to third parties. The use of mechanical restraints and the infrequent existence of disease awareness on the part of the patient.

In terms of social and occupational dysfunction, this is a medical student who suffers intense stress in with third year exams, which triggers the disease, leaving evidence of her vulnerability. Finally, continued family support from the patient's mother is an important factor in the final cure, while relations with her sister suffer a significant deterioration, jealousy and feelings of shame because of the disease are clear.3


Schizophrenia is a disease that occurs in outbreaks and after each episode the capacities are more and more diminished. It is therefore doubtful to think of a complete recovery without sequelae, but there remains, as the title of the film indicates, a thread of hope.

In Spain, the reorganization of health care related to mental health with the creation of Mental Health Units and the associative network of friends and relatives of the mentally ill are a contribution to the fight against this real crossroads of medicine that is schizophrenia.


The film shows the problems and difficulties to manage a psychotic illness like Schizophrenia based in the treatment in the community, and the basic role of the family, but also is necessary the adoption of measures that defends the rights of the persons with problems of mental health.



Conflicts of interest

The author declares no competing interests.


Creative Commons Attribution License

©2024 Fernández. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.