A cold of the soul: a Japanese case of disease mongering in psychiatry

Int J Risk Saf Med. 2012;24(2):115-20. doi: 10.3233/JRS-2012-0560.


In Japan, depression provides the most drastic example of the impact of disease awareness campaigns. Until the late 1990 s, the public's attitude toward depression was generally unfavorable, due to the negative connotations of the Japanese word for clinical depression, 'utsubyou'. After the 1999 introduction of the first selective serotonin re-uptake inhibitor, pharmaceutical companies initiated educational campaigns. In order to aid the drug's acceptance, they coined the catchphrase 'kokoro no kaze', which literally means 'a cold of the soul'. Thanks to these marketing practices, antidepressant sales have increased six fold, from ¥ 14.5 billion in 1998 to ¥ 87 billion in 2006. However, the catchphrase 'kokoro no kaze' masked a critical difference between a cold and depression. It falsified the nature of treatment for depression by concealing the putative duration of medication. Owing to this distortion of information, pharmaceutical companies were assured a steady stream of profits. Now, the pharmaceutical industry is shifting its focus from depression to bipolar disorder. Japanese psychiatrists can learn a great deal from their experience with the aggressive marketing of antidepressants. In the case of depression, over-medication arguably did more harm than good. The same risk exists with other conditions, including bipolar disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antidepressive Agents, Second-Generation / economics
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Attitude to Health*
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / economics
  • Depressive Disorder / diagnosis
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / economics
  • Drug Industry / economics*
  • Drug Industry / methods
  • Drug Industry / standards
  • Female
  • Health Services Misuse
  • Humans
  • Japan
  • Male
  • Marketing of Health Services / economics*
  • Marketing of Health Services / methods
  • Marketing of Health Services / standards
  • Mental Disorders
  • Selective Serotonin Reuptake Inhibitors / economics
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Social Stigma*
  • Terminology as Topic


  • Antidepressive Agents, Second-Generation
  • Serotonin Uptake Inhibitors