in Thinking about psychiatry


The term “schizophrenia” was coined by Swiss psychiatrist Eugen Bleuler in 1908.  With the term’s introduction, Bleuer ultimately replaced ‘dementia praecox‘, a term first used by Arnold Pick (of Pick’s disease) to categorize a similar disorder (or group of disorders).  The essence of schizophrenia as described by Bleuler is the ‘loosening of the associations’ between personality, thinking, memory and perception.  Dementia praecox has a different focus, describing patients having a global disruption of perceptual and cognitive processes (dementia) together with early onset (praecox).  I’ve written about different conceptions of schizophrenia in the past.

The word “schizophrenia” derives from Greek roots and translates approximately as “splitting of the mind”.  It is often written that, because of this, schizophrenia is misconstrued to mean having a split or multiple personality.  Otherwise known as ‘dissociative identity disorder‘ a ‘split personality’ is where a person has two or more distinct identities or personalities alternatively in control of his or her behaviour.  I’m not absolutely convinced this disorder exists in a straightforward sense but anyway, our current understanding of schizophrenia is that it’s nothing like that at all.

“Starbucks is a schizophrenic brand”

This brings me to the point I wish to make.  For affected people, and their families, schizophrenia can be pretty devastating.  But rather than simply used to refer to this, “schizophrenic” is also used quite commonly to mean “inconsistent and contradictory”.  Here’s an example from Radio 4’s Today programme and another from the Guardian.  Today’s presenter, Evan Davies, doesn’t hesitate at talk of Starbucks as a “schizophrenic brand”.  “Irish” used to be used in quite a similar way, but I doubt Davies could have let talk of Starbucks as an “Irish brand” pass without reproof.  “Schizophrenic” used in this way is a misappropriation, and one which perpetuates misunderstanding and disparages a vulnerable group of people.  I don’t know why it remains so acceptable.



Inquiry into the schizophrenia label has published on whether we should use the term ‘schizophrenia’ at all

I haven’t read it, but this book – American Madness: the rise and fall of dementia praecox – looks v. interesting.  It charts how DP lost out to schizophrenia in the nosology ‘arms race’.



(June 2018 review – Evan Davies now presents Newsnight; I don’t know if he still uses ‘schizophrenic’ in the above sense.

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  1. Good observation. I have had similar concerns about the use of this term in the media and frequently by reporters who should know better. In many situations I think you are being very charitable by saying they are using it as a term that means “inconsistent and contradictory”, although that certainly seem to be the context in this story. The majority of people who ask me about the meaning of the word think it means either “split personality” or “multiple personalities” and are quite surprised by the practical and useful definition.

    I don’t think we can minimize the well documented effect of negative press coverage of everything psychiatric.

  2. Schizophrenia is an idea, not a medical condition. Therefore you cannot blame the layman (or journalist) for misunderstanding psychiatrists if you continue to diagnose people with an idea of an illness.

  3. I can’t say it any better than Seymour Kety did nearly 40 years ago:

    “If schizophrenia is a myth, it is a myth with a strong genetic component!”

    But I also realize that there is no scientific evidence for global warming or evolution. They are both first rate ideas.

    Am J Psychiatry (1974) 131: p 961.

  4. The Guardian style guide, I believe, counsels against using “schizophrenic” in this sense, so it’s disappointing if they’ve started slipping into this lazy, inaccurate usage.

    @George Dawson – no scientific evidence for global warming eh? I’m not sure where you’re getting your info from, but from my reading it’s a set of hypotheses with an increasingly strong data set to support, sadly, some of the more catastrophic predictions.

  5. The AP Stylebook has issued new guidelines for how to write about mental illness in general, with schizophrenia mentioned as one to watch with care. Perhaps journalists will be more sensitive from here on.

    I agree that as a descriptor, “schizophrenic” has become far too commonly applied, and often erroneously.