Mental health conditions can be very challenging and complex, given the overlap in features across multiple conditions. When looking at the difference between schizophrenia and dissociative identity disorder, it is important to understand the nature of the disorders, their symptoms, onset, risk facts, and brain function.
What Is Dissociative Identity Disorder (DID)?
Dissociative identity disorder (DID) is a condition that was previously referred to as multiple personality disorder. This means that individuals struggle with two or more distinct personalities or identity fragments alongside recurrent amnesia, whereby they do not necessarily recall the other identity. DID can present with psychosis, but this is not one of the primary features. It is, instead, a dissociative disorder, which means there are disruptions to consciousness, memory, and even identity.
What Is Schizophrenia?
Schizophrenia is a significant mental health disorder that presents with disorganized thoughts, delusions, and hallucinations, all of which fall under the category of psychosis. With schizophrenia, individuals struggle with symptoms of an altered perception, meaning their perception of reality is different from actual reality. This is considered a psychotic disorder.
Dissociative Identity Disorder vs. Schizophrenia: Key Differences
If you are looking at dissociative identity disorder and schizophrenia, it is important to recognize key differences.
Nature of the Disorders
With dissociative identity disorder vs schizophrenia, one difference is that people with DID have multiple personalities or identities. This is not the case with schizophrenia.
Symptoms and Manifestations
Another difference between schizophrenia and dissociative identity disorder is that those with DID have a fragmented sense of self, and the multiple personalities or identities can have different characteristics. By comparison, those who have schizophrenia have disturbing beliefs, behaviors, thoughts, or emotions but not identity fragments.
Causes and Risk Factors
For DID, causes and risk factors include things like:
- Emotional, sexual, or physical abuse in childhood
- Childhood neglect
- Frightening and unstable family environments growing up
- Exposure to natural disasters, war, torture, or kidnapping
By comparison, schizophrenia can be caused by several things like:
- A family history of schizophrenia
- A stressful or dangerous environment, not just growing up but in teenage or young adult years
- Complications during pregnancy
- Changes to brain structure and function
- Substance abuse
Onset and Progression
One difference between dissociative identity disorder and schizophrenia is the onset. Schizophrenia is not commonly diagnosed until the late teens through early thirties. However, someone with DID develops the condition early in childhood, often after a traumatic event.
Treatment
With schizophrenia vs dissociative identity disorder, the treatment might seem the same (both with medication and therapy), but the prescriptions are different. For schizophrenia, a prescription of antipsychotics is more common, but for DID, a prescription of antidepressants is more common.
Diagnosing Dissociative Identity Disorder and Schizophrenia
When getting a diagnosis for dissociative identity disorder vs. schizophrenia, it’s important that you go to a qualified mental health professional who will conduct a clinical evaluation based on the diagnostic criteria for different disorders.
The purpose of the clinical evaluation is to rule out symptoms that may be better explained by other conditions.
Diagnostic Criteria in DSM-5
Dissociative identity disorder diagnostic criteria require that an individual have at least two or more distinct personality states as well as disruption in identity to such a degree that individuals don’t have a good sense of self. With DID, individuals experience recurrent gaps when they try to recall their daily events, or they can’t recall personal information, all of which relates to the concept that a different personality State took over, resulting in minor amnesia. The symptoms have to be severe enough to cause clinical distress and are not related to religious or cultural behaviors.
Schizophrenia requires that an individual present with two or more of the following, one of which must be one of the first three, for a significant amount of time during a one-month period:
- Delusions
- Hallucinations
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms
for a significant portion of the time when these symptoms are happening, it must significantly interfere with regular daily function like self care and interpersonal relationships and signs must persist for a minimum of 6 months, not better explained by other conditions.
Common Diagnostic Challenges
DID can be misdiagnosed as schizophrenia. Both conditions can present in people who have a history of trauma and can present with symptoms of psychosis.
Role of Mental Health Professionals
It’s imperative that you work with a trained mental health professional who can recognize the subtle differences between these two so that you can get an accurate diagnosis and, from there, personalized treatment.
Treatment Approaches for Dissociative Identity Disorder and Schizophrenia
When looking at the difference between dissociative identity disorder and schizophrenia, there may be overlap in terms of what treatment approaches happen, but the types of therapy and the types of medications prescribed differ.
Psychotherapy for DID
For DID, therapy is the most common form of treatment because it allows people to integrate different identities, develop coping skills, and control symptoms. Some of the most common forms of therapy for DID include psychotherapy, CBT, DBT, and schema therapy.
Medication for Schizophrenia
For schizophrenia, the main form of treatment is medication, including antipsychotics. First-generation antipsychotics or typical antipsychotics, as well as second-generation or atypical antipsychotics, can be prescribed.
Combining Therapies
For schizophrenia, it’s important that treatment be combined with other non-pharmacological options like skills training, support networks, and therapy. For any mental health condition, the use of therapy will increase the efficacy of any medication prescribed, which is why combining therapies is very common.
Conclusion
There are major differences between dissociative identity disorder and schizophrenia. What they do have in common is that the psychosis associated with schizophrenia can manifest with dissociative identity disorder. However, it is imperative that anyone experiencing these symptoms have a better awareness of schizophrenia vs. dissociative identity disorder and seek an accurate diagnosis so that treatment can be tailored to your needs.