OBJECTIVE: To determine whether schizophrenia is a commonly used 'illness as metaphor', to compare the use of schizophrenia and cancer as illnesses as metaphor, and to determine if there is a difference in such usage between the UK and USA. DESIGN: An examination of articles published in the British press. SETTING: 600 articles from six British newspapers: the Times, the Daily Telegraph, the Guardian, the Mirror, the Sun and the Daily Mail. MAIN OUTCOME MEASURES: Use of schizophrenia and cancer as metaphors. RESULTS: Schizophrenia was more likely to be metaphorized than cancer (P<0.001) in the UK press, but was less likely to be used as metaphor in the UK press than in the US press (P<0.001). 11% of articles containing the term schizophrenia used the word as a metaphor. CONCLUSIONS: Clinicians need to be aware that patients, carers and the public might have a different understanding of the word we use as a diagnosis.