Interpersonal stigma and positive experiences in relationships for people living with schizophrenia spectrum and other complex disorders, with and without co-occurring substance use disorders

Stigma in interpersonal relationships is a barrier to social engagement, recovery, and well-being for people living with complex mental health conditions. Among people living with these conditions, individuals who experience schizophrenia spectrum disorders (SZ) face particularly high levels of stigma. Many individuals living with complex mental health conditions experience co-occurring substance use disorders (SUD), which may compound the effects of interpersonal stigma. However, little research has examined stigma in interpersonal relationships for people living with co-occurring complex mental health conditions and SUD, including co-occurring SZ and SUD (SZSUD). This study analyzed qualitative data from 90 Australians living with SZ, SZSUD, and co-occurring SUD and complex mental health conditions other than SZ collected as part of the National Stigma Report Card’s Our Turn to Speak survey. A thematic analysis examined and compared perceived experiences of interpersonal stigma and positive treatment in relationships with friends, family members, and intimate partners between these groups. Four themes were identified: “social disconnection,” “negative and degrading judgements,” “loss of power and control,” and “the pillars of positive relationships.” While participants in all three groups described similar types of experiences in their relationships, certain experiences were only reported by people living with either SZ or SUD. In many cases, participants living with SZSUD described both types of experiences. These findings provide preliminary support for the theory that people who experience co-occurring complex and highly stigmatized conditions, such as SZSUD, face compounded stigma in interpersonal relationships due to the combined effects of stigma associated with each condition.

Interpersonal communication · Psychiatry · Psychosis · Psychotherapist · Schizophrenia (object-oriented programming · Schizophrenia Spectrum · Stigma (botany · Substance use · Child and Adolescent Psychosocial and Emotional Development · Clinical Psychology · Family Caregiving in Mental Illness · Mental Health Treatment and Access · Psychology · Social Psychology

• Nursing students' perceptions of an anti-stigma intervention for schizophrenia

  Open Access•Jing Wang, Hong Wang et al.•Frontiers in Public Health•2026

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