Use of the first-person pronoun in schizophrenia

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. ¹ One of their hypotheses concerned the use of the first-person singular pronoun ‘I’. On the basis of research showing patients with mood disorders to be particularly self-focused, as well as 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’. They found this hypothesis to be supported by their data.

One obvious limitation of this study, admitted by the authors, is the lack of a healthy control group. Data from two such control groups, however, are readily at hand. First, one can compare the word frequencies found in their first-person accounts with their frequency in general language, as represented in reference corpora such as the Corpus of Contemporary American English. ² Second, in order to compare a text format that is as similar as possible to first-person accounts of mental illness, one can make use of articles published in the Schizophrenia Bulletin under the rubric ‘First-person account’ that are not written by sufferers of schizophrenia, but by (supposedly) healthy family and friends of someone with schizophrenia (I will refer to those as ‘second-person’ accounts). Such comparison, based on analyses of a corpus of the Schizophrenia Bulletin using CQPsoftware, ³ yields results that markedly differ from Fineberg et al’s findings (for a general introduction to corpus linguistics, see Lüdeling & Kytö ⁴ ).

Since 1979, the Schizophrenia Bulletin has published 98 first-person accounts and 30 second-person accounts of schizophrenia. The frequency of ‘I’ in the first-person accounts is 34 621.67/106 words and 20 804.18/106 words in the second-person accounts. The authors of the first-person accounts use ‘I’ 3.34 times more often than it is used in general American English and 1.90 times more often than it occurs in general spoken American English. Comparing first- and second-person accounts, ‘I’ is used 1.66 times more often by people identifying as having 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 having 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. To further investigate the relationship between language and self-disturbances, it would be 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.