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Publication

Examination of stigmatizing language within medical literature on psychosis

Monahan, Zach
Stone, Tanner
Swami, Vinay
Hartwell, Micah
Abstract
Background: Conditions of psychosis have been the subject of significant stigma, leading to delayed treatment for individuals experiencing early symptoms of psychosis, for fear of being labeled “crazy” or “psychotic.” Delayed treatment can worsen the prognosis of individuals with psychosis. Proper adherence to person-centered language guidelines can curb the widely-held stigmatized preconceptions about psychotic conditions. The objective of this paper is to determine the rate of adherence to person-centered language (PCL) guidelines among published literature on schizophrenia and other conditions of psychosis.
Methods: We began with a systematic search of literature in PubMed discussing schizophrenia or psychosis from 2020-2022. Our analysis included the articles of journals which had published at least 20 articles on the subject. Among search results, we randomly selected 500 articles, of which 241 articles met inclusion criteria. These papers were screened for usage of stigmatized language, and the article type, research focus, and institution type were noted for further analysis.
Results: Preliminary results reveal that 54.0% (121/224) of articles screened included stigmatized language, such as labels or emotional phrases. The most common stigmatized phrase identified was “schizophrenia patient,” found in 35.7% of papers. “Schizophrenic [patient/subject/etc]” was found in 12.5% of papers. The type of intervention was the only variable which was found significant for PCL guidelines adherence, with 55.4% (103/186) of “no treatment (purely observational)” articles including stigmatized language, compared to 32.7% (18/55) of all other types. Type of article, research, funding, and institution were not found significant for PCL adherence. These preliminary results do not include papers which are inaccessible, and awaiting ILL.
Conclusion: The majority of medical articles screened did not adhere to PCL guidelines. Usage of stigmatized language in literature reinforces the use of these labels in medical education, in doctor’s offices, and in popular culture. Given the impact of stigma on treatment delay -and the poor prognosis that may result- proper care should be taken to enforce person-centered language in medical literature. Reducing the fear of labeling is a necessary step in encouraging treatment for people experiencing early symptoms of psychosis.
Date
2024-02-16