In recent years, the debate surrounding the language used to describe individuals with schizophrenia has gained significant momentum within academic and clinical communities alike. A groundbreaking study published in the 2025 edition of Schizophrenia journal by Dino, Koga, Yokoji, and colleagues sheds new light on the nuanced preferences and implications of person-first versus identity-first language in scholarly articles. This research not only challenges longstanding linguistic norms but also underscores the profound impact word choice can have on stigma, identity, and mental health advocacy.
Language shapes perception. This foundational principle forms the core of the study, which meticulously analyzes a broad range of academic publications to discern patterns in how researchers refer to people diagnosed with schizophrenia. The authors differentiate between two linguistic frameworks: person-first language, which prioritizes the person before the diagnosis (e.g., “person with schizophrenia”), and identity-first language, which integrates the diagnosis as an inseparable aspect of the individual’s identity (e.g., “schizophrenic person”). Their findings reveal a complex tapestry of preferences aligned with evolving perspectives on mental illness, agency, and social identity.
From a clinical neuropsychiatry standpoint, person-first language has historically been championed as a means to combat stigma by emphasizing the humanity and individuality behind diagnostic labels. The notion is that defining individuals primarily by their illness risks dehumanization and exclusion. This approach finds its roots in disability advocacy movements that advocated for dignity and social integration by challenging reductive labels. However, in the context of schizophrenia — a disorder with profound cognitive, emotional, and perceptual alterations — this linguistic convention may inadvertently contribute to distancing and alienation.
Conversely, identity-first language reflects a paradigm shift prioritized by many in the neurodiversity community who argue that psychiatric diagnoses form inextricable elements of their lived experience and self-conception. Embracing identity-first terminology can empower individuals by fostering acceptance and dismantling internalized stigma. In the case of schizophrenia, where symptoms can be integral to shaping cognition and behavior, identifying as a “schizophrenic” may convey ownership and resilience rather than pathology alone. The study illuminates this perspective’s rising prominence among contemporary researchers and advocates alike.
The methodological rigor of Dino et al.’s investigation involved a comprehensive corpus analysis of thousands of peer-reviewed articles spanning multiple decades. Their quantitative and qualitative metrics captured shifts over time in phraseology and contextual usage across disciplines including psychiatry, psychology, social work, and neuroscience. Remarkably, the researchers observed a gradual but definitive increase in identity-first language usage, correlating with broader socio-cultural movements emphasizing neurodiversity and mental health normalization. This contrasted with earlier decades’ near-exclusive reliance on person-first constructions.
One of the study’s critical technical insights pertains to the intersectionality of language preferences with variables such as geographic region, research focus, and publication venue. For example, biomedical journals tended to favor person-first language consistent with clinical objectivity, whereas social science journals demonstrated more frequent identity-first terminology reflecting advocacy and lived experience narratives. Geographic disparities emerged, with North American publications usually adhering to person-first norms, while European and Australian literature showed increasing fluidity and adoption of identity-first forms.
Moreover, the authors engage with the neurobiological underpinnings that nuance the discourse on language and identity in schizophrenia. Advances in neuroimaging and genetic research reinforce the notion that schizophrenia is linked to complex brain network alterations and developmental factors that shape cognitive architecture. This scientific context adds depth to the linguistic debate: if schizophrenia-related neural traits are intrinsic to an individual, does that validate identity-first language as more authentic or accurate descriptives? The paper explores this question without prescribing conclusively, instead advocating for flexibility and respect for individual preference.
The impact on clinical communication emerges as another pivotal dimension of the study. The words clinicians and researchers use influence patient outcomes through shaping self-perception, therapeutic alliance, and stigma reduction. The authors argue that fixed, universal rules regarding terminology risk overlooking personal nuances that can make or break engagement in mental health care. They urge practitioners to adopt a dialogical approach, encouraging patients to express their linguistic selves and integrating these preferences into person-centered care models.
Furthermore, the study highlights ethical considerations in academic writing and editorial policy. Publishers and reviewers hold significant power in setting standards for acceptable language, which in turn influences research culture and public discourse. Dino et al. recommend updating journal guidelines to accommodate both person-first and identity-first terms, provided they are used with clarity and respect. Such policies can validate multiple experiences and reflect the heterogeneity of schizophrenia itself.
The authors also address the sociolinguistic phenomenon of reappropriation, where historically pejorative terms can be reclaimed by communities to subvert stigma and assert identity. The gradual shift towards identity-first language in some circles mirrors this process, challenging previous pathologizing labels. This dimension adds a meta-communicative layer to the analysis: language choices are not merely descriptive, but actively enact social power dynamics and resistance.
Importantly, the research situates its linguistic analysis within a broader public health framework. Schizophrenia remains highly stigmatized worldwide, with consequences ranging from social isolation to reduced access to services. Language reform is one among many strategies to improve outcomes by fostering inclusivity and decreasing discrimination. Dino and colleagues emphasize the need to combine linguistic sensitivity with systemic changes in policy, education, and advocacy for maximal impact.
In conclusion, the comprehensive study by Dino et al. challenges entrenched assumptions about how best to linguistically represent individuals with schizophrenia in academic literature. Their nuanced evaluation of person-first and identity-first language reveals evolving trends, the significance of context, and the critical importance of respect for individual preference. By bridging psychiatric, sociological, and linguistic perspectives, the research offers a template for more inclusive, empowering discourse that aligns with contemporary values of neurodiversity and mental health advocacy.
This evolving lexical landscape is poised to influence future research methodologies, clinical practice, and societal attitudes. As our understanding of schizophrenia deepens through neuroscientific discoveries and the voices of those affected gain prominence, the words we escolha will continue to shape the narrative around mental illness. Dino and colleagues’ work invites ongoing reflection on how language can either reinforce stigma or foster dignity—ultimately underscoring that in psychiatry, as elsewhere, words truly matter.
Subject of Research: How academic researchers refer to individuals with schizophrenia, examining the use of person-first versus identity-first language in scholarly papers.
Article Title: How researchers refer to individuals with schizophrenia: person-first and identity-first language in academic papers.
Article References:
Dino, M., Koga, G., Yokoji, A. et al. How researchers refer to individuals with schizophrenia: person-first and identity-first language in academic papers. Schizophr. (2025). https://doi.org/10.1038/s41537-025-00692-0
Image Credits: AI Generated
