The Use of Person-Centered Language (PCL) in Bipolar Disorder Research: A Cross-Sectional Study.

Stigma is defined as a constellation of negative social beliefs, attitudes, and perceptions that become affixed to a particular characteristic of an individual (APA Dictionary of Psychology, 2018). Within the field of psychiatry, such characteristics frequently pertain to aspects of a person’s mental, physical, or social health. When these attributes are marked by stigma, they can provoke profound social disapproval, giving rise to unjust discriminatory behaviours that marginalise affected individuals and, critically, deter them from seeking, engaging in, or continuing treatment aimed at improving their wellbeing. Among the mental health conditions most persistently burdened by stigma and public misunderstanding is bipolar disorder, a severe and recurrent mood disorder estimated to affect approximately 37 million people worldwide (WHO, 2025). Bipolar disorder is characterised by marked and episodic fluctuations in mood, energy, activity levels, and cognitive functioning. Individuals living with the condition experience periods of elevated mood and increased activity, referred to as mania or hypomania, alternating with episodes of profound depression. As described by Jain and Mitra (2023), “bipolar disorder (BD) is characterised by chronically occurring episodes of mania or hypomania alternating with depression and is often misdiagnosed initially, underscoring both its clinical complexity and vulnerability to misunderstanding”. Despite substantial advances in the diagnosis, classification, and treatment of bipolar disorder, stigma remains deeply entrenched and continues to exert a powerful influence on public attitudes, patterns of help-seeking, and both clinical and scientific discourse. Language plays a central role in sustaining or dismantling these perceptions. The terms used to describe individuals with bipolar disorder, specifically within scientific and medical literature, possess the capacity to either foster empathy, dignity, and respect, or to perpetuate stereotypes, blame, and social distance. The consequences of stigmatising language are not merely theoretical. Empirical evidence demonstrates that stigma is internalised by many individuals living with bipolar disorder, with profound effects on functioning and recovery. In a study by Grover et al. (2016), approximately 28% of patients reported moderate to high levels of self-stigma as measured by the Internalised Stigma of Mental Illness Scale (ISMIS). Experiences of discrimination were the most frequently reported domain of stigma (38.9%), followed by alienation (28.6%) and social withdrawal (28.6%). Alarmingly, nearly two-fifths (42%) of participants reported severe restrictions in daily activities, indicating a tangible erosion of social participation. These findings illustrate how stigma (reinforced through societal narratives and professional discourse) can become embedded within the lived experience of bipolar disorder, shaping illness trajectories and quality of life. In recognition of the power of language, the American Psychiatric Association (APA) and the American Medical Association advocate for the consistent use of person-centred language (PCL) in both clinical and scientific contexts. The central principle of PCL is the prioritisation of the individual over the diagnosis, thereby discouraging reductive labels, emotive phrasing, and moralised or outdated terminology. By foregrounding personhood rather than pathology, PCL seeks to mitigate stigma and promote a more humane, recovery-oriented discourse. Although PCL has been increasingly embedded within clinical guidelines, editorial policies, and institutional frameworks, existing evidence elucidates that its adoption within scientific literature remains inconsistent. To date, there has been no comprehensive cross-sectional investigation examining the extent to which person-centred versus stigmatising language is employed in research publications focused specifically on bipolar disorder. This absence is important to note given the demonstrable impact of stigma on clinical outcomes, functioning, and participation among individuals with the condition. Accordingly, the present study seeks to address this critical gap by conducting a cross-sectional analysis of peer-reviewed scientific literature on bipolar disorder published between 2015 and 2025. Following the methodological framework established by prior investigations of person-centred language in psychiatric research, such as studies focusing on psychosis, attention-deficit/hyperactivity disorder, and depression, this research aims to systematically evaluate linguistic practices within the bipolar disorder literature. In doing so, it endeavours to illuminate the ways in which scientific language may either challenge or perpetuate stigma, and to contribute empirical evidence capable of informing more ethical, precise, and person-centred standards in psychiatric publishing. The primary objective of this study is to assess the prevalence and nature of non–person-centred, stigmatising language in peer-reviewed scientific articles focused on bipolar disorder. This research aims to quantify the frequency with which research articles deploy ‘identity-first labels’ (e.g., “bipolar patient”), emotive or victimising language (e.g., “suffers from bipolar”), pejorative descriptors, or outdated diagnostic terminology, in contrast to person-centred, diagnosis-respectful phrasing.