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Word use in first-person accounts of schizophrenia

  • S. K. Fineberg (a1), S. Deutsch-Link (a2), M. Ichinose (a3), T. McGuinness (a3), A. J. Bessette (a3), C. K. Chung (a4) and P. R. Corlett (a5)...



Language use is often disrupted in patients with schizophrenia; novel computational approaches may provide new insights.


To test word use patterns as markers of the perceptual, cognitive and social experiences characteristic of schizophrenia.


Word counting software was applied to first-person accounts of schizophrenia and mood disorder.


More third-person plural pronouns (‘they’) and fewer first-person singular pronouns (‘I’) were used in schizophrenia than mood disorder accounts. Schizophrenia accounts included fewer words related to the body and ingestion, and more related to religion. Perceptual and causal language were negatively correlated in schizophrenia accounts but positively correlated in mood disorder accounts.


Differences in pronouns suggest decreased self-focus or perhaps even an understanding of self as other in schizophrenia. Differences in how perceptual and causal words are correlated suggest that long-held delusions represent a decreased coupling of explanations with sensory experience over time.

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Corresponding author

P. R. Corlett, Connecticut Mental Health Center, Yale University School of Medicine, Department of Psychiatry, 34 Park Street, New Haven, CT 06519, USA. Email:


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See invited commentary, pp. 39–40, this issue.

This work was supported by the Connecticut State Department of Mental Health and Addiction Services. P.R.C. was funded by an IMHRO/Janssen Rising Star Translational Research Award and CTSA Grant Number UL1 TR000142 from the National Center for Research Resources (NCRR) and the National Center for Advancing Translational Science (NCATS), components of the National Institutes of Health (NIH), and NIH roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH. S.K.F. was supported by NIMH Grant #-5T32MH019961, ‘Clinical Neuroscience Research Training in Psychiatry’. C.K.C. was supported by the Army Research Institute, Grant #W5J9CQ12C0043.

Declaration of interest




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Word use in first-person accounts of schizophrenia

  • S. K. Fineberg (a1), S. Deutsch-Link (a2), M. Ichinose (a3), T. McGuinness (a3), A. J. Bessette (a3), C. K. Chung (a4) and P. R. Corlett (a5)...
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The first-person in schizophrenia: Response to Fineberg et al. 2014

Anke Maatz, speciality trainee in psychiatry and postdoctoral research fellow
12 August 2014

In their recent publication, Fineberg et al. examined word use in first-person accounts of schizophrenia in comparison with word use in first-person accounts of mood and anxiety disorders (2014). One of their hypotheses concerned the use of the first-person singular pronoun 'I': based on research showing patients with mood disorders to be particularly self-focused as well as on phenomenological reports by patients suffering from schizophrenia describing a disrupted sense of self, they predicted "that writers with schizophrenia would use 'I' less often than persons with mood disorder." (p.1) They found this hypothesis to be supported by their data (p.3)

One obvious limitation of this study, admitted by the authors, is thelack of a healthy control group. Data from two such control groups howeverare readily at hand: Firstly, one can compare the word frequencies found in the first-person accounts to their frequency in general language as represented in reference corpora such as the Corpus of Contemporary American English COCA ( Secondly, in order to compare to a format of text as similar as possible to first-person accounts of mental illness, one can make use of those articles published in the Schizophrenia Bulletin under the rubric "First person account" which are not written by sufferers of schizophrenia, but by (supposedly) healthy family and friends who equally write about their personal experience of schizophrenia but from a second-person perspective (I refer to those as second-person accounts). Such comparison, based on analyses ofa corpus of the Schizophrenia Bulletin using CQP software (Hardie 2012), yields results that markedly differ from Fineberg et al.'s findings (for ageneral introduction to corpus linguistics see e.g. Luedeling&Kytoe 2009). Since 1979, the Schizophrenia Bulletin has published 98 first-person accounts of schizophrenia and 30 second-person accounts. The frequency of 'I' in the first-person accounts is 34621.67/106 words and 20804.18/106 words in the second-person accounts. Compared to standard American English, one finds that the authors of the schizophrenia first-person accounts use 'I' 3.34 times more often than it is used in general AmericanEnglish and still 1.90 times more often than it occurs in general Americanspoken English. Comparing first- and second-person accounts, one finds that 'I' is used 1.66 times more often by people identifying as suffering from schizophrenia spectrum disorders than by their mentally healthy friends and family members. The log likelihood test shows this difference to be significant (p < 0.01).

Authors identifying as suffering from schizophrenia thus use the first-person singular pronoun more often than healthy controls. Therefore,Fineberg et al.'s finding that authors with schizophrenia use 'I' less often than authors with mood disorders does not warrant any inferences regarding pathologies of the self in schizophrenia. Further investigating the relationship between language and self-disturbances, it seems desirable to analyse linguistic data from people undergoing an acute psychotic episode as well as to consider pronouns in their wider grammatical context rather than looking at mere word frequencies.

References:Corpus of Contemporary American English. Available at: SK, Deutsch-Link S, Ichinose M, McGuiness T., Bessette AJ, Chung CK, Corlett PR. Word use in first-person accounts of schizophrenia. Br Journal Psychiatry 2014; doi: 10.1192/bjp.bp.113.140046.Hardie A. CQPweb - combining power, flexibility and usability in a corpus analysis tool. International Journal of Corpus Linguistics 2012; 17 (3): 380-409.L?deling A & Kyt? M. Corpus Linguistics - An International Handbook. De Gruyter, 2009.

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Conflict of interest: None declared

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