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Disclosing the Diagnosis of Schizophrenia

Int J Soc Psychiatry; ePub 2019 Mar 27; Setti, et al

An intervention in individuals with schizophrenia found that the “Coming Out Proud” (COP) intervention facilitated participants’ disclosure decisions, and the increasing awareness of stigma as a stressor in life may have facilitated their decision to eventually disclose their disorder. The pilot study consisted of 3 2-hour group lessons (6-12 participants) per week. The final sample included 31 participants. Outcomes were assessed before and after the COP intervention and at 3-week follow-up. Researchers found:

  • Those who completed the COP intervention showed a significant increase in the decision to disclose their diagnosis.
  • As to the perception of stigma as a stressor, mean values significantly increased after the intervention.
  • 2 results had marginal significance: self-stigma was reduced while perceived discrimination increased.


Setti VPC, Loch AA, Modelli, A, et al. Disclosing the diagnosis of schizophrenia: A pilot study of the ‘Coming Out Proud’ intervention. [Published online ahead of print March 27, 2019]. Int J Soc Psychiatry. doi:10.1177/0020764019840057.


Stigma is defined as a mark of disgrace associated with a particular circumstance, quality, or person. Many psychiatric disorders, including schizophrenia, are highly stigmatizing and cause both societal stigma (discrimination/shunning of those with the condition) as well as internalized stigma where individuals incorporate negative and stigmatizing beliefs into their own self-identity. The “Coming Out Proud” (COP) program is a relatively brief intervention which appears to help people with schizophrenia increase awareness of stigma as a stressor and may help with appropriate disclosure. The study also points out that stigma is a 2-way street. While it is helpful to reduce internalized stigma, as a society we need to make more progress in creating inclusive and accepting views of individuals with psychiatric conditions. —Martha Sajatovic, MD, Professor of Psychiatry and of Neurology; Willard Brown Chair in Neurological Outcomes Research; Director, Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center; Case Western Reserve University School of Medicine.