A qualitative study of illness identity: schizophrenia and depression

  • Namino Ottewell | ottewelln@ml1.net School of Social Sciences, Waseda University, Tokyo, Japan.


Illness identity refers to the interpretation of having mental illness in persons who regard themselves as mentally ill. Illness identity can impact people diagnosed with mental illness negatively. However, little is known about the background of illness identity. This study aimed to investigate the process whereby mental health service users accept their diagnosis and develop an illness identity and to compare the processes between schizophrenia and depression. Twenty persons with schizophrenia and depression were interviewed, and the data were analysed using grounded theory approach. The major findings were as follows: i) while those with schizophrenia were shocked by their diagnosis and took time to accept it, this was not true for those with depression; ii) for participants with depression, it was relatively easy to accept their diagnosis, as they thought that depression was a normal illness; participants with schizophrenia needed to learn about their illness, know the efficacy of psychiatric medication and reduce their prejudice against mental illness to accept their diagnosis; and iii) participants’ illness identity encompassed sickness and normality with sickness being related to taking psychiatric medication and normality being associated with having regular work, acting as other people do or living in the community. These findings suggest the influence of social attitudes to each illness on illness identity and the complex nature of illness identity.



PlumX Metrics


Download data is not yet available.


McCarthy-Jones S, Marriott M, Knowles R, Rowse G, Thompson AR. What is psychosis? A meta-synthesis of inductive qualitative studies exploring the experience of psychosis. Psychosis. 2013;5(1):1-16. DOI: https://doi.org/10.1080/17522439.2011.647051

Yanos PT, Roe D, Lysaker PH. The Impact of Illness Identity on Recovery from Severe Mental Illness. Am J Psychiatr Rehabil. 2010;13(2):73-93. DOI: https://doi.org/10.1080/15487761003756860

Griffiths KM, Nakane Y, Christensen H, Yoshioka K, Jorm AF, Nakane H. Stigma in response to mental disorders: a comparison of Australia and Japan. BMC Psychiatry. 2006;6:21. DOI: https://doi.org/10.1186/1471-244X-6-21

Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG. "A disease like any other"? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J psychiatry. 2010;167(11):1321-30. DOI: https://doi.org/10.1176/appi.ajp.2010.09121743

Corbin J, Strauss A. Basics of qualitative research. 3rd ed. London: Sage; 2008.

Iwadate T, Ushijima S, Ohno Y, et al. Results of questionnaire on the term and concept of schizophrenia. Psychiatr et Neurologia Japonica. 1996; 98, 245-265 (in Japanese).

Sato M. Renaming schizophrenia: a Japanese perspective. World Psychiatry. 2006; 5, 53-55.

Takahashi H, Ideno T, Okubo S, Matsui H, Takemura K, Matsuura M, et al. Impact of changing the Japanese term for "schizophrenia" for reasons of stereotypical beliefs of schizophrenia in Japanese youth. Schizophr Res. 2009;112(1-3):149-52. DOI: https://doi.org/10.1016/j.schres.2009.03.037

Koike S, Yamaguchi S, Ojio Y, Shimada T, Watanabe K, Ando S. Long-term effect of a name change for schizophrenia on reducing stigma. Soc Psychiatry Psychiatr Epidemiol. 2015;50(10):1519-26. DOI: https://doi.org/10.1007/s00127-015-1064-8

Knight MTD, Wykes T, Hayward P. 'People don't understand': An investigation of stigma in schizophrenia using interpretative phenomenological analysis (IPA). J Mentl Health. 2003;12:209 – 222 DOI: https://doi.org/10.1080/0963823031000118203

Pitt L, Kilbride M, Welford M, et al. Impact of a diagnosis of psychosis: user-led qualitative study. Psychiatr Bull. 2018;33:419-23. DOI: https://doi.org/10.1192/pb.bp.108.022863

Kurihara T, Kato M, Sakamoto S, Reverger R, Kitamura T. Public attitudes towards the mentally ill: a cross-cultural study between Bali and Tokyo. Psychiatry and clin neurosci. 2000;54:547-52. DOI: https://doi.org/10.1046/j.1440-1819.2000.00751.x

Masuda A, Hayes SC, Twohig MP, et al. Comparing Japanese international college students’ and U.S. college students’ mental-health-related stigmatizing attitudes. J Multicul Couns D. 2009; 37, 178-189.

Kako Y, Okubo R, Shimizu Y, et al. A multicenter study regarding schizophrenia patients' notification of the diagnosis. Psychiatr et Neurologia Japonica. 2014; 116, 813-824 (in Japanese).

Nishimura Y. The influence of the term change of schizophrenia on doctor’s giving a notice about diagnosis to patients. Jap J Psychiatr Nurs. 2004; 31, 38-42 (in Japanese).

Moran GS, Oz G, Karnieli-Miller O. Psychiatrists' challenges in considering disclosure of schizophrenia diagnosis in Israel. Qual Health Res. 2014;24(10):1368-80. DOI: https://doi.org/10.1177/1049732314547085

Outram S, Harris G, Kelly B, Cohen M, Sandhu H, Vamos M, et al. Communicating a schizophrenia diagnosis to patients and families: a qualitative study of mental health clinicians. Psychiatric services (Washington, DC). 2014;65(4):551-4. DOI: https://doi.org/10.1176/appi.ps.201300202

Interian A, Martinez IE, Guarnaccia PJ, Vega WA, Escobar JI. A qualitative analysis of the perception of stigma among Latinos receiving antidepressants. Psychiatr Serv. 2007;58(12):1591-4. DOI: https://doi.org/10.1176/ps.2007.58.12.1591

Moses T. Self-labeling and its effects among adolescents diagnosed with mental disorders. Soc Sci Med. 2009;68(3):570-8. DOI: https://doi.org/10.1016/j.socscimed.2008.11.003

Tucker I. “This is for Life”: A discursive analysis of the dilemmas of constructing diagnostic identities. Forum: Qualit Soc Research. 2009; 10 Art. 24. (12)

Korsbek L. Illness insight and recovery: how important is illness insight in peoples' recovery process? Psychiatr Rehabil J. 2013;36(3):222-5. DOI: https://doi.org/10.1037/prj0000018

Hamilton B, Roper C. Troubling 'insight': power and possibilities in mental health care. Journal of psychiatric and mental health nursing. 2006;13(4):416-22. DOI: https://doi.org/10.1111/j.1365-2850.2006.00997.x

Original Articles
Illness identity, Mental illness, Depression, Schizophrenia.
  • Abstract views: 3132

  • PDF: 915
How to Cite
Ottewell, Namino. 2018. “A Qualitative Study of Illness Identity: Schizophrenia and Depression”. Qualitative Research in Medicine and Healthcare 2 (2). https://doi.org/10.4081/qrmh.2018.7420.