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Learn the differences between dissociative identity disorder and schizophrenia, including their different causes, treatments, signs and symptoms, and diagnosis.
Schizophrenia and dissociative identity disorder may have some overlapping symptoms. Hence, it may often be tricky to clinically differentiate between the two diseases.
In both of these conditions, affected people develop a sense of fragmented reality. Between 9 and 50 percent of people with schizophrenia meet the criteria for a dissociative disorder. Thus, the diagnosis of schizophrenia is not an exclusive diagnosis but a complicated one.
Although they are similar, learn the differences between dissociative identity disorder and schizophrenia below, which includes how they differ in their cause, treatment, signs and symptoms, and diagnosis.
How do dissociative identity disorder and schizophrenia differ in their cause?
Doctors do not clearly know what causes dissociative identity disorder and schizophrenia. However, having a history of trauma, neglect, or physical abuse during childhood increases a person’s risk of dissociative identity disorder, which commonly begins between 5 and 10 years.
Many of the affected people find dissociation as a way to detach themselves from painful or unpleasant experiences.
- Nearly 90 percent of affected people have a history of neglect or physical or sexual abuse during their formative years.
- Although a combination of genetic factors, environmental factors, and chemical changes in the brain is involved in the development of schizophrenia, exposure of the expectant mother to factors such as viral infections, psychological distress, and malnutrition can increase her baby’s risk of schizophrenia in the late teen years, the 20s or 30s.
Schizophrenia is more common in people with a genetic predisposition to the disease with the events of the intrauterine period, maternal drug history, and environmental factors playing a supporting role.
How do dissociative identity disorder and schizophrenia differ in their treatments?
The treatment of schizophrenia includes a combination of therapies such as:
- Medications (second-generation antipsychotic medications, also known as atypical antipsychotics, are the first line of treatment)
- Psychotherapy such as behavior therapy
- Family support or family psychoeducation
- Community-based treatment programs
Unlike antipsychotics that are approved by the U.S. Food and Drug Administration to treat schizophrenia, there is no medication approved for dissociative identity disorder. Talk therapy is the only treatment that works for dissociative identity disorder; hence, it is the main treatment for the condition.
Talk therapy or psychotherapy is focused on talking with a mental health therapist who helps the person understand their symptoms and causes and teaches them ways to manage the disorder.
Types of talk therapy include:
- Cognitive-behavioral therapy
- Dialectical behavioral therapy
Other therapies used for dissociative identity disorder include:
- Hypnotherapy: Clinical hypnosis can be used to help release repressed emotions of troublesome memories and control some of the erratic behaviors that accompany dissociated identity disorder.
- Adjunctive therapy: Also known as movement therapy, art therapy has been shown to help people cope with trauma.
How do dissociative identity disorder and schizophrenia differ in their signs and symptoms?
When a person has dissociative identity disorder, they have multiple personalities, whereas they experience hallucinations when they have schizophrenia.
Although the mind of a person with schizophrenia may be filled with mental chaos and disorder, someone with dissociative identity disorder can be extremely organized when they are in one alter.
People with schizophrenia see the world in a way that is perceived differently than normal people, but they don’t have multiple distinct personalities as seen in people with a dissociative identity disorder.
Affected people of both disorders, schizophrenia and dissociated identity disorder, are seen to have memory loss (amnesia), but it is more common in the latter.
- According to studies, people with dissociative personality disorder have higher rates of derealization and depersonalization.
- Depersonalization involves detachment from oneself, whereas individuals with derealization feel detached from their surroundings as if the world around them is visually distorted.
- People with schizophrenia may experience depersonalization and derealization, but this is uncommon as compared to dissociative identity disorder.
Cognitive impairment is more commonly seen in schizophrenia than in dissociative disorders.
How are schizophrenia and dissociative identity disorders diagnosed?
Diagnosing schizophrenia or dissociative identity disorders is a challenging task for doctors due to the high chances of co-occurrence of these two conditions or other overlapping conditions.
If a person thinks that they have any of these symptoms, they should seek the help of a mental health professional for an evaluation. If they are not sure about their diagnosis, they can even consider getting a second opinion.
To diagnose any mental health condition, the doctor or mental health professional will ask questions about symptoms, take a medical history, and perform a physical examination.
- If they suspect any physical disease that causes the symptoms, they may order blood tests or other diagnostic tests to rule out any such diseases.
- They will use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose whether the person has schizophrenia, dissociative identity disorder, or any other mental conditions.
- The DSM-5 enlists the criteria that a person must meet to be diagnosed with a specific condition.
