What is the difference between schizophrenia and multiple personality disorder

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What’s the difference between schizophrenia and multiple personality disorder?

Q:

A: Schizophrenia, from the Greek roots schizein (σχίζειν, “to split”) and phrēn, phren- (φρήν, φρεν-, “mind”), is a psychiatric diagnosis that describes a mental illness characterized by impairments in the perception or expression of reality, most commonly manifesting as auditory hallucinations, paranoid or bizarre delusions or disorganized speech and thinking in the context of significant social or occupational dysfunction. Onset of symptoms typically occurs in young adulthood,[1] with approximately 0.4–0.6%[2][3] of the population affected. Diagnosis is based on the patient’s self-reported experiences and observed behavior. No laboratory test for schizophrenia exists.Studies suggest that genetics, early environment, neurobiology and psychological and social processes are important contributory factors. Current psychiatric research is focused on the role of neurobiology, but a clear organic cause has not been found. Due to the many possible combinations of symptoms, there is debate about whether the diagnosis represents a single disorder or a number of discrete syndromes. For this reason, Eugen Bleuler termed the disease the schizophrenias (plural) when he coined the name. Despite its etymology, schizophrenia is not synonymous with dissociative identity disorder, previously known as multiple personality disorder or split personality; in popular culture the two are often confused===============================================Dissociative Identity Disorder (DID), as defined by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), is a mental condition whereby a single individual evidences two or more distinct identities or personalities, each with its own pattern of perceiving and interacting with the environment. The diagnosis requires that at least two personalities routinely take control of the individual’s behavior and that there is associated memory loss that goes beyond normal forgetfulness, often referred to as losing time or acute Dissociative Amnesia[1]. The symptoms of DID must not be the direct result of substance abuse or a more general medical condition in order to be diagnosed. DID was originally named Multiple Personality Disorder (MPD), and, as referenced above, that name remains in the International Statistical Classification of Diseases and Related Health Problems.This condition is not an equivalent for schizophrenia (DSM-IV Schizophrenia and Other Psychotic Disorders), as is a common misconception. The term schizophrenia comes from root words for “split mind,” but refers more to a fracture in the normal functioning of the brain, than the personality. It makes people think they are two or more different people===============================================

What’s the difference between Multiple Personality Disorder and Schizophrenia?

Q:

A: There are huge differences beginning with the fact that Schizophrenia is biologically based and requires medication whereas Multiple Personality (aka DID) is trauma-based and does not respond well to meds. The similarity that often leads people to confuse the two disorders is auditory hallucinations. In DID, the voices are generally experienced as coming from inside one’s head and represent a form of internal communicatiin between dissociated parts of the self-in Schizophrenia the voices are usually experienced as coming from outside and may involve delusions of thought insertion as well as multiple other psychotic symptoms.Here is some info from my previous posts whish I hope will illustrate the enormous difference between the disorders and their treatment: DID (MPD)DID is the existence of two or more separate personalities or personality states within one person, with each alter having distinctly different ways of thinking, feeling, behaving and relating to the world and distinctly different memories, each part having amnesia for the other parts’ memories. It is born from repeated and severe abuse and involves the defense mechanism of dissociation and generally develops before the age of 10 as children are far more likely to dissociate. DID is often misdiagnosed and it is very common for a person to have had multiple different psychiatric diagnoses before it is definitively identified as DID. The symptoms frequently overlap with symptoms of schizophrenia, Bipolar Disorder, Depression, Anxiety Disorders (all), PTSD, other Dissociative Disorders and Somatoform Disorders as well as Borderline Personality. It requires extremely careful assessment and a high level of trust by the patient before alters reveal themselves. The diagnosis cannot be finalized before a therapist has actually made contact with another alter and observed the switch between alters.The hallmark symptom is amnesia, which can be partial or complete depending on the level co-consciousness that exists between alters. Folks with the disorder describe the amnesia as “missing time” or blank periods, often daily or weekly, where they cannot account for their whereabouts or behavior. It is this amnesic barrier between parts that often leads to the most bizarre and distinctive signs and symptoms: not recognizing familiar people; not remembering highly significant events in their lives (like the birth of their first child, for example); finding purchases or articles of clothing/possessions, writings or drawings that they have no recollection of having bought or created. They are frequently accused of lying because they disavow their own behavior which is remembered by one part, while the amnestic part is completely unaware of it. Other unusual symptoms include: an exceptionally high tolerance for physical pain (they split off physical sensation which becomes encapsulated in one or several alters without others feeling it); not recognizing themselves in a mirror; using different names; having dramatically different skills and abilities that seem to be alternately present and then vanish (one alter may be able to drive a car while the sudden emergence of a child alter results in complete loss of this ability until the adult alter re-emerges); completely different opinions and behaviors (leading to the mislabeling of Bipolar or Borderline Personality.Often communication across between separate alters takes place in the form of hearing voices, hence these folks frequently get misdiagnosed as schizophrenic. The key distinction here is whether the voices are experienced as coming from inside the person’s head (DID) or outside one’s head (Schizophrenia/Bipolar Disorder). The separate identities develop in response to traumatic experiences which the child is unable to integrate and so they become “split off” from awareness and begin to take on a life of their own. Folks with DID often self-injure, frequently a result of internal battles between persecutor alters and weaker alters and there are continual battles for control of the body and “time out” in the body between competing alters. Symptoms of depression and anxiety are frequent and common and the picture is further complicated by the fact that one alter can meet all clinical criteria for Depression, while another part experiences no symptoms whatsoever. One part can be psychotic and experience no side effects from meds while another non-psychotic part has all the side effects and will stop taking meds. You can imagine that attempting to medicate such a disorder becomes an absolute nightmare.Other symptoms include flashbacks and nightmares, hence the confusion with PTSD. Sometimes there are fugue states and clients will switch and “come to” in the body and have no idea how they arrived in the situation they are in, not know the people they are with and be completely disoriented. I had one client call me from another state after being away for a few days and having no idea how she got there or how to get home. Depersonalization and trance states are common and hence the overlap with other Dissociative disorders.Folks with DID frequently experience multiple somatic symptoms for which there is no organic basis. They experience partial body memories of abuse without the actual memory of the event and thus exhibit strange physiological symptoms and are often labeled as Somatoform disorders or hypochondriacs. I could go on and on, but suffice it to say that virtually any symptom of any disorder can be found at some point in a person with DID. Treatment is almost exclusively through psychotherapy as medication is merely palliative and an adjunct during periods of acute anxiety or depression. Treatment aims at initially contracting against suicidal and self-destructive behavior and attempts to establish safety first. Many DID folks enter treatment in horrendous circumstances where they are frequently in highly abusive relationships or are themselves abusive. Given the multiple alters, they may be both victim and perpetrator both within themselves alone and in the context of their relationships. The second primary goal is establishing communication and negotiation among alters to decrease amnesia and contradictory, self-defeating behavior. Ultimately the goal becomes integration of alters into one cohesive whole which involves sharing of memories and feelings across alters and a merging, where all parts continue to be present, but constant.Treatment stages:I do believe that integration is the eventual goal in therapy with folks for DID as I see anything less than that as settling for less than a person deserves, though I respect the choices people make as to how far they wish to go in therapy. But integration most certainly is possible.Initially I focus on contracting to decrease overtly self-destructive behavior in order to allow therapy to proceed. This contracting can take weeks or months before all parts are willing to get on board and suspend overtly self-destructive behavior as there is usually a lack of understanding by each part that what they do effects all parts. Safety of the body has to come first before other work takes place in order to avoid hospitalization or injury which will only delay and interfere with therapy.The first step in therapy then is always establishing communication between alter parts. Sometimes this happens initially through a journal where each part can write or post comments to a question. Once there has been some initial communication and awareness of other parts, communication is fostered through developing co-consciousness which is the ability for one part to stay “present” while another part or parts are dominant. Mainly, this involves a willingness to stay and resist the desire to dissociate. The greater the degree of co-consciousness, the less amnesia there is and the less confusion the person experiences. The next step is to facilitate cooperation between parts and decrease the internal struggles and battles for control which lead to disorganized behavior and inconsistency in relationships. This often is somewhat like family therapy and the basic tenet is to encourage openness to understanding the perspectives and needs of other parts within the system. The most important thing here is to encourage respect for other parts-it is also one of the most difficult aspects of the therapy as negative attitudes by the host personality toward other parts is generally the source of most conflict. The other parts’ behaviors are interpreted out of context and are often perceived by the host as destructive or persecutory. Other parts often are angry with the host and see the host as weak and dependent. It’s my experience that persecutor alters are every bit as valuable and important and necessary to the system and are really protector parts in disguise, no matter how horrendous or destructive their behavior may appear at first on the surface. This step is crucial, as communication will shut down and no further work will take place without establishing respect between alters and a willingness and desire to learn from one another. Each alter offers unique coping strategies and needs to be honored for the role they played in the system’s survival. Initial cooperation and collaboration among alters may begin with simply negotiating things like who has time out in the body and when. Clearly, a degree of respect needs to precede this in order to facilitate the trust necessary to allow alters to voluntarily take control. This also diminishes the severe headaches which usually result from switching struggles.Once there has been a level of communication and cooperation established, the next step is to facilitate sharing of memories across alters which further reduces the amnesia barrier. It also results in the transfer of skills between parts and a dramatic increase in empathy for what each part experienced and the contribution they made to survival. The greatest roadblock to accomplishing this step is usually host resistance, as the host is reluctant to accept the dissociated memories and the attendant emotional pain and they must become committed to the goal of accepting the other parts of themselves and owning the experiences and the pain. This leads to integration.When alters integrate by sharing the emotions and the memory, they never actually leave or disappear-they simply cease to exist as separate. This is key as no part is ever eliminated (which sometimes is what the host personality strives to do-trying to destroy or suppress a part is a negative barrier and not possible either) as each is equally crucial to the person’s evolving sense of self. Other alters fear loss of independence and uniqueness and their role and often resist too at this stage until the concept is fully understood. Acceptance of all parts directly results in integration. All of these fears of loss of separateness, loss of coping by dissociation need to be processed to facilitate this stage.The last stage is usually grieving with all the anger, sadness and feelings that come with owning the experiences of horrific abuse, and sometimes worse, the emotional neglect. Grieving the loss of the parents you never had is the most apt phrase I’ve ever heard and is credited to Colin Ross, the guru in treatment of DID. Finally there is a resolution phase, where as clients call it, they adjust to being a “monomind” and coping with new experiences without the use of dissociation or other ways of avoiding affect (like alcohol, drugs, self-mutilation, rage episodes or other forms of acting out) and they practice and solidify the coping mechanisms they have been learning throughout therapy.Hope this helps explain the process. Again, just a reminder-DID and PTSD are among the only psychiatric disorders which can be truly “cured” and also do not depend on meds for management of symptoms.SchizophreniaSchizophrenia is an illness that is biogically based. You inherit a predisposition for the disorder which is generally triggered by stress. The precise genetic mechanism is not clear, but it appears that multiple genes are involved so it is difficult to predict exact rates for inheritance patterns. The genetic component is demonstrated via twin studies which show concordance rates to be significantly higher between identical twins than between fraternal twins who have genetic make-ups that are the same as siblings. However, concordance rates among identical twins are not nearly 100%, thus there is clearly an environmental component to the disorder.The typical age of onset is in the late teens to early 20’s (the college years).The general characteristics include both “positive” (acute) symptoms and “negative” (residual) symptoms and there is a prodromal phase, acute phases and residual phases. There are a lot of technical aspects to the correct diagnosis which I won’t elaborate, but in general the characteristic signs are any combination of the following:”Positive” signs:-Hallucinations (primarily auditory, less often visual and rarely tactile, gustatory or olfactory)-Delusions (fixed or variable, paranoid/persecutory and grandiose, somatic, erotomanic, nihilistic, etc.-they run the gamut of various types, “ideas of reference” where a person believes that random events have a special meaning meant just for them, delusions of thought control or thought insertion)-Disorganized Thinking (“Loose associations” where thoughts are strung together with little cohesiveness, “perseveration” where a person gets stuck on the same thought or theme over and over like a needle that skips on a record and keeps replaying ) -Disorganized Behavior (catatonic excitement, catatonic stupor which is like posturing-usually only seen in extremely severe cases and rarely any more)-Poor Concentration and inability to focus on a thought, sometimes “blocking” where a thought becomes interrupted in midstream)-Disorganized speech (incoherence, rambling or circumstantial speech-lots of fancy terms like echolalia, word salad, verbigeration, clanging)-Inappropriate Affect (inappropriate giggling, tears, silliness, etc. that is out of context to the situation)”Negative” signs:-social withdrawal and preference to isolate-flattened or blunted affect (emotional expression)-Amotivation (lack of motivation, apparent apathy)Prodromal symptoms are less acute and precede the “active” phase where the “positive” symptoms become prominent. A prodrome often looks like a Schizoid or Schizotypal Personality Disorder where you tend to see things like emotional blunting, social withdrawal, odd or eccentric behavior, sometimes manifested in certain unusual preoccupations, idiosyncratic thinking that strikes people as “odd” rather than outright bizarre. For example, strange beliefs that are uncharacteristic, reading hidden and overly personal messages into random events or preoccupation with signs and symbols. Auditory hallucinations may begin at this point and people may wear headphones constantly to drown out the voices or become obsessed with unplugging electrical appliances, etc., believing them to be the source of the stimuli. Again, these are only examples and not present in every case. Outward signs that observers notice tend to be centered around decreased attention to hygiene and appearance generally (like wearing the same clothes for days on end without washing them), disrupted sleep patterns, a more distant interpersonal stance or odd habits that seem out of character, like avoiding certain foods, colors, places, etc. or always wearing a certain item.There are 5 distinct types:1-Paranoid: most organized thinking of the types-prominent delusions and hallucinations2-Disorganized (Hebephrenic): Grossly disorganized thinking and behavior predominates and inappropriate affect with grimacing, giggling, etc. unrelated to the situational context3-Catatonic: catatonia, with waxy flexibility, posturing or catatonic excitement rarely seen any more4-Undifferentiated: no clear predominant symptoms5-Residual: Primary negative symptoms-often seen as a “burned out” version where there are fewer positive or acute symptomsSchizophrenics often are able to maintain jobs in low stress environments with minimal interpersonal demands once they are stabilized. Others may work in sheltered employment with support and guidance. Social skills are greatly impaired and schizophrenics often have great difficulty reading the social cues most of us take for granted and thus they misjudge or misread social situations which reinforces their tendency to self-isolate as do paranoid symptoms. Intimacy is exceptionally difficult as well and they rarely form close or deep bonds with others, making it difficult to function as husbands and parents. They tend to appear aloof and distant emotionally, although often this is a way of coping with feelings of being overwhelmed by other people’s emotional expression and demands.Medication often serves to either completely control the acute symptoms or dampen their impact, but tends to have minimal impact on the negative symptoms. The side effects are often horrendous and intolerable and this leads to a familiar pattern of stopping medication, beginning the trend of repeated courses of decompensation leading to re-hospitalization.The ineffectiveness of meds and the emotional blunting they can cause often leads to attempts to self-medicate with alcohol or marijuana (usually) which often increase symptoms.Schizophrenics often perceive the world in unique and idiosyncratic ways which can cause them difficulty in complying with social norms and expectations, even simple things like generally accepted standards for cleanliness or hygiene. It can also lead them to exceptional creativity and expression in arts and abstract disciplines. Examples of famous schizophrenics are the poet and artist, William Blake (I have many of his works in my office for inspiration) and John Nash, the Nobel Prize winner featured in the movie “A Beautiful Mind”.

What’s the difference between schitzophrenia and multiple personality disorder?

Q: My understanding of schitzophrenia is that a person suffering from it might hallucinate sights, sounds, and even smells, etc., but the way it’s always portrayed in movies and on TV is that schitzophrenics “hear voices” in their head and have split personalities. What are the true definitions of these conditions, and how are they different? Are they different names for the same thing, or is multiple personality disorder caused by schizophrenia?

A: Schizophrenia is actually not at all the same thing as dissociative identity disorder, also known as multiple personality disorder. actually, DID is so rare that its validity as a disorder is questioned by some psychologists, and very little is known about it. what is known is that it is more common in women, and more common still in women who have experienced sexual abuse. the separate personality or personalities which split from the original are often opposite the person’s original personality, and often unknown, at least at first, to the original personality. also, the first split personality generally knows about the others, and often establishes itself as the “controller” of the others. schizophrenia means “split mind,” but in the sense of being split from reality, not split into parts. it is extremely debilitative and people suffering from it often experience hallucinations (usually in the form of voices), paranoia, catatonia, and illogical thought, among other things.ok, the above was all information learned in psych class, and below is a link on each:http://www.sidran.org/didbr.htmlhttp://www.psychologynet.org/schiz.html