Psychiatric Quarterly

, Volume 84, Issue 1, pp 93–102 | Cite as

When and How Should I Tell? Personal Disclosure of a Schizophrenia Diagnosis in the Context of Intimate Relationships

  • Mary V. Seeman
Review Paper


Clinicians are frequently asked for advice on what to tell prospective marriage partners about a history of mental illness. The aim of this paper is to develop guidelines for disclosure. An electronic search was conducted of the stigma, secrecy, communication, sociology, and matchmaking literatures as they pertain to mental illness, especially to schizophrenia. The conclusion was that pre-existing psychiatric conditions must be shared with prospective marriage partners once these partners have proven trustworthy. The recommendation is that disclosure be done in stages and that discussions continue, with attempts made to address all relevant issues and address the partner’s concerns. Although schizophrenia does not define who a person is, the diagnosis and its implications are important and need to be shared with prospective marriage partners.


Schizophrenia Disclosure Concealment Marriage Stigma 


  1. 1.
    Charlotte. Comment. In: Difference Is the Norm on These Dating Sites. 28 Dec 2010. Accessed 15 March 2012
  2. 2.
    Coyne D. The Relationship “Comedy” of Mental Illness. 26 Sept 2011. In: Healthyplace. Accessed 15 March 2012
  3. 3.
    Jamie Please. How would you disclose a mental illness to a would be date? 1/6/07 In: PlentyOfFish. Accessed 15 March 2012
  4. 4.
    qt_tibbs. How Would You Disclose a Mental Illness to a Would be Date? 1/6/2007 In: PlentyOfFish Accessed 15 March 2012
  5. 5.
    LowKeyDifferent. How Would You Disclose a Mental Illness to a Would be Date? 1/6/2007 In: PlentyOfFish Accessed 15 March 2012
  6. 6.
    GS. Comment. In: Difference Is the Norm on These Dating Sites. 27 Dec 2010 Accessed 15 March 2012
  7. 7.
    Chaudoir SR, Fisher JD. The disclosure processes model: Understanding disclosure decision making and postdisclosure outcomes among people living with a concealable stigmatized identity. Psychological Bulletin 136:236–256, 2010PubMedCrossRefGoogle Scholar
  8. 8.
    Greene K, Magsamen-Conrad K, K. Venetis MK, Checton MG, Bagdasarov Z, Banerjee SC. Assessing health diagnosis disclosure decisions in relationships: Testing the disclosure decision-making model. Journal of Health Communication. 2011 Oct 12 [Epub ahead of print]Google Scholar
  9. 9.
    Ragins BR. Disclosure disconnects: Antecedents and consequences of disclosing invisible stigmas across life domains. Academy of Management Review. 33:194–215, 2008CrossRefGoogle Scholar
  10. 10.
    Pandya A, Bresee C, Duckworth K, Gay K, Fitzpatrick M. Perceived impact of the disclosure of a schizophrenia diagnosis. Community Mental Health Journal 47:613–621, 2011PubMedCrossRefGoogle Scholar
  11. 11.
    Fett AK, Shergill SS, Joyce DW, Riedl A, Strobel M, Gromann PM, Krabbendam L. To trust or not to trust: the dynamics of social interaction in psychosis. Brain 135:976–984, 2012PubMedCrossRefGoogle Scholar
  12. 12.
    Humphrey Beebe L. What community living problems do persons with schizophrenia report during periods of stability? Perspectives in Psychiatric Care 46:48–55, 2010CrossRefGoogle Scholar
  13. 13.
    Evensen J, Røssberg JI, Barder H, Haahr U, ten Velden Hegelstad W, Joa I, Johannessen JO, Larsen TK, Melle I, Opjoerdsmoen S, Rund BR, Simonsen E, Sundet K, Vaglum P, Friis S, McGlashan T. Apathy in first episode psychosis patients: A ten year longitudinal follow-up study. Schizophrenia Research 136:19–24, 2012PubMedCrossRefGoogle Scholar
  14. 14.
    Angell B, Test MA. The relationship of clinical factors and environmental opportunities to social functioning in young adults with schizophrenia. Schizophrenia Bulletin 28:259–271, 2002PubMedCrossRefGoogle Scholar
  15. 15.
    Serretti A, Chiesa A. A meta-analysis of sexual dysfunction in psychiatric patients taking antipsychotics. International Clinical Psychopharmacology 26:130–40, 2011PubMedCrossRefGoogle Scholar
  16. 16.
    Seeman MV. Antipsychotics and physical attractiveness. Clinical Schizophrenia & Related Psychoses 5:142–146, 2011PubMedCrossRefGoogle Scholar
  17. 17.
    Hinshaw SP. Stigma as related to mental disorders. Annual Review of Clinical Psychology 4:367–393, 2008PubMedCrossRefGoogle Scholar
  18. 18.
    Stier A, Hinshaw SP. Explicit and implicit stigma against individuals with mental illness. Australian Psychologist 42:106–117, 2007CrossRefGoogle Scholar
  19. 19.
    Green S, Davis C, Karshmer E, Marsh P. Straight B. Living stigma: the impact of labeling, stereotyping, separation, status loss, and discrimination in the lives of individuals with disabilities and their families. Social Inquiry 75:197–215, 2005CrossRefGoogle Scholar
  20. 20.
    Anonymous. Unlucky in love? Try Dating With a Mental Illness. 15 Sept. 2010 In: Mind. Accessed 15 March 2012
  21. 21.
    Wright ER, Wright DE, Perry BL, Foote-Ardah CE. Stigma and the sexual isolation of people with serious mental illness. Social Problems 54:78–98, 2007CrossRefGoogle Scholar
  22. 22.
    Agerbo E, Byrne M, Eaton WW, Mortensen PB. Marital and labor market status in the long run in schizophrenia. Archives of General Psychiatry 61:28–33, 2004PubMedCrossRefGoogle Scholar
  23. 23.
    Caughlin JP, Scott AM, Miller LE, Hefner V. Putative secrets: When information is supposedly a secret. Journal of Social and Personal Relationships 26:713–743, 2009CrossRefGoogle Scholar
  24. 24.
    Barretto M, Ellemers N, Banal S. Working under cover: Performance related self-confidence among members of contextually devalued groups who try to pass. European Journal of Social Psychology 36:337–352, 2006CrossRefGoogle Scholar
  25. 25.
    Pachankis JE. The psychological implications of concealing a stigma: A cognitive-affective-behavioral model. Psychological Bulletin 133:328–345, 2007PubMedCrossRefGoogle Scholar
  26. 26.
    Renfrow DG. A cartography of passing in everyday life. Symbolic Interaction 27:485–506, 2004CrossRefGoogle Scholar
  27. 27.
    Flanagan EH, Davidson L. Passing for “normal”: features that affect the community inclusion of people with mental illness. Psychiatric Rehabilitation Journal 33:18–25, 2009PubMedCrossRefGoogle Scholar
  28. 28.
    Joachim G, Acorn S. Living with chronic illness: The interface of stigma and normalization. Canadian Journal of Nursing 32:37–48, 2000Google Scholar
  29. 29.
    Baxter LA, Wilmot WW. Taboo topics in close relationships. Journal of Social and Personal Relationships 2:253–269, 1985CrossRefGoogle Scholar
  30. 30.
    Knobloch LK, Carpenter-Theune KE. Topic avoidance in developing romantic relationships. Associations with intimacy and relational uncertainty. Communication Research 31:173–205, 2004Google Scholar
  31. 31.
    Caughlin JP, Afifi WA, Carpenter-Theune, KE., Miller LE. Reasons for, and consequences of, revealing personal secrets in close relationships: A longitudinal study. Journal of Social and Personal Relationships 12:43–59, 2005CrossRefGoogle Scholar
  32. 32.
    Lippert T, Prager KJ. Daily experiences of intimacy: A study of couples. Personal Relationships 8:283–298, 2001CrossRefGoogle Scholar
  33. 33.
    Sprecher S, Hendrick SS. Self-disclosure in intimate relationships: Associations with individual and relationship characteristics over time. Journal of Social and Clinical Psychology 23:857–877, 2004CrossRefGoogle Scholar
  34. 34.
    Finkenauer C, Kerkhof P, Righetti F, Branje S. Living together apart: perceived concealment as a signal of exclusion in marital relationships. Personality and Social Psychology Bulletin 35:1410–1422, 2009PubMedCrossRefGoogle Scholar
  35. 35.
    Finkenauer C, Engels RCME, Branje S, Meeus W. Disclosure and relationship satisfaction in families. Journal of Marriage and Family 66:195–209, 2004Google Scholar
  36. 36.
    Kerr NL, Levine JM. The detection of social exclusion: Evolution and beyond. Group Dynamics Theory Research 12:39–52, 2008CrossRefGoogle Scholar
  37. 37.
    Williams KD. Ostracism. Annual Review of Psychology 58:425–452, 2007CrossRefGoogle Scholar
  38. 38.
    Twenge JM, Baumeister RF, DeWall CN, Ciarocco NJ, Bartels JM. Social exclusion decreases prosocial behavior. Journal of Personality and Social Psychology 92:56–66, 2007PubMedCrossRefGoogle Scholar
  39. 39.
    DeWall CN, Deckman T, Pond RS Jr., Bonser I. Belongingness as a core personality trait: How social exclusion influences social functioning and personality expression. Journal of Personality 79:1281–1314, 2011PubMedCrossRefGoogle Scholar
  40. 40.
    Angermeyer M, Matschinger H. Public beliefs about schizophrenia and depression: similarities and differences. Social Psychiatry and Psychiatric Epidemiology 38, 526–34, 2003PubMedCrossRefGoogle Scholar
  41. 41.
    Behere PB, Sathyanarayana Rao TS, Verma K. Effect of marriage on pre-existing psychoses. Indian Journal of Psychiatry 53:287–288, 2011PubMedCrossRefGoogle Scholar
  42. 42.
    Gagoomal PJ. A “margin of appreciation” for “marriages of appreciation”: Reconciling South Asian adult arranged marriages with the matrimonial consent requirement in international human rights law. Georgetown Law Journal 97:589–620, 2008Google Scholar
  43. 43.
    Santosh D, Kumar TS, Sarma PS, Radhakrishnan K. Women with onset of epilepsy prior to marriage: disclose or conceal? Epilepsia 48:1007–1010, 2007PubMedCrossRefGoogle Scholar
  44. 44.
    Thara R, Srinivasan TN. Outcome of marriage in schizophrenia. Social Psychiatry and Psychiatric Epidemiology 32:416–420, 1997PubMedGoogle Scholar
  45. 45.
    Jordan DK. Chinese Matchmakers of Tiānjīn & Táoyuán. In: Conference on Anthropological Studies in Taiwan. Institute of Ethnology, Academia Sinica, March 21–23, 1997. Accessed 15 March 2012
  46. 46.
    Seeman MV. Assortative mating. Psychiatric Services 63:174–175, 2012CrossRefGoogle Scholar
  47. 47.
    Bronstein M. Cultural and Religious Factors in the Acceptance or Resistance to Mental Health Treatment in Three Subgroups of the Orthodox Community. Dissertation. Union Institute and University 2007, 141 pages, 3255228 Accessed 15 March 2012
  48. 48.
    Schnall E. Multicultural counseling and the Orthodox Jew. Journal of Counseling & Development 84:276–282, 2006CrossRefGoogle Scholar
  49. 49.
    Sublette E, Trappler B. Cultural sensitivity training in mental health: Treatment of orthodox Jewish psychiatric inpatients. International Journal of Social Psychiatry. 46:122–134, 2000PubMedCrossRefGoogle Scholar
  50. 50.
    Mintz AR, Dobson KS, Rommey DM. Insight in schizophrenia: a meta-analysis. Schizophrenia Research 61:75–88, 2003PubMedCrossRefGoogle Scholar
  51. 51.
    Checton MG, Greene K. Beyond initial disclosure: The role of prognosis and symptom uncertainty in patterns of disclosure in relationships. Health Communication 2:145–157, 2012CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of PsychiatryUniversity of TorontoTorontoCanada

Personalised recommendations