title: Stigma and bipolar disorder: a review of the literature.
abstract: BACKGROUND
  Psychiatric stigma is pervasive injustice that complicates the course of illness and reduces quality of life for people with mental illnesses. This article reviews the research examining stigma towards bipolar disorder (BD) with a view to guiding the development of stigma reduction initiatives and ongoing research.
  
  
  METHODS
  PsychInfo, Medline, and Embase databases were searched for peer-reviewed studies addressing stigma in BD.
  
  
  RESULTS
  Stigma is a serious concern for individuals with BD and their families. Stigma occurs within affected individuals, families, social environments, work and school environments, and the healthcare industry. With stigma often come a loss of social support and occupational success, reduced functioning, higher symptom levels and lower quality of life. BD stigma is comparable to that of other severe mental illnesses, such as schizophrenia. Few interventions are available to specifically target stigma against BD.
  
  
  CONCLUSIONS
  Most studies have used explicit, attitude-based measures of stigma without controlling for social desirability, which may not translate into real-world stigmatizing behaviors. Furthermore, many studies have not clearly delineated results in a manner consistent with the conceptual framework of stigmatization.
  
  
  CONCLUSIONS
  Stigma toward BD is ubiquitous and has insidious consequences for affected individuals and their families. Stigma reduction initiatives should target individuals living with BD, their families, workplaces, and the healthcare industry, taking into account the experiences and impacts of BD stigma to improve social support, course of illness, and quality of life.
authors.affiliation: University Health Network, Toronto Western Hospital, 399 Bathurst St., Toronto, ON, Canada, M5T 2S8. lisa.hawke@outlook.com
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Hawke
authors.forename: Sagar V
authors.initials: SV
authors.lastname: Parikh
authors.forename: Erin E
authors.initials: EE
authors.lastname: Michalak
mesh_terms: D001714:Bipolar Disorder / Q000523:psychology*; D006801:Humans; D012106:Research / Q000639:trends; D057545:Social Stigma; D012944:Social Support; D013240:Stereotyping; D017132:Workplace
keywords: Attitudes; Bipolar disorder; Functioning; Quality of life; Stigma