Schizophrenia/Dissociative I.D Disorder

Split Personality isn't Schizophrenic Symptom

The term 'schizophrenic' is sometimes casually used to describe someone who seems to bounce back and forth between interests or whose personality seems to vary depending on the private or professional environment, yet this behaviour is indicative of Dissociative Identity Disorder (DID), and not schizophrenia - in fact, the two conditions are unrelated.

Schizophrenia Defined: Positive, Negative and Cognitive Symptoms

The Diagnostic and Statistical Manual of Mental Disorders 4th Edition Text Revised (DSM-IV-TR) defines symptoms. For diagnosis of schizophrenia two or more must be present for "a significant portion of time during a 1-month period." Schizophrenia is a complex disorder. The symptoms are often classified as positive, negative and cognitive.

• 'Positive' symptoms are those that are present in the sufferer, but wouldn't be in a healthy individual, ie delusions and hallucinations.
• 'Negative' symptoms describe features that are absent in the sufferer but wouldn't be in a healthy individual; verbal ability like Alogia (difficulty speaking, short empty replies to questions), emotional expression including Affective Flattening (reduction of range and intensity of facial expression, voice tone, eye contact, inability to interpret or use appropriate body language), motivation, interest in regular activities, friends, and socializing.
• Cognitive symptoms relate to problems with memory and decision making.

There are 6 types of schizophrenia: Paranoid; Disorganised; Catatonic; Residual; Schizoaffective; Undifferentiated. Diagnosis will depend on the symptoms present. Typically the average age of onset is 18 in men and 25 in women.

Kinds of Delusions or False Beliefs

• Paranoid delusions - people are "out to get" you or you are being followed or watched.
• Delusions of reference - environmental factors are directly communicating with you; the T.V, radio or other media are sending you personal messages.
• Somatic delusions - believing you have a serious physical illness or that there is a foreign object inside you.
• Delusions of grandeur - believing that you are extraordinarily gifted with special powers or abilities.
• Hallucinations - seeing, hearing, feeling, smelling or tasting things that are not really there; commonly hearing voices, distinct from one's own thoughts.

Disorganization Speech & Behaviour and Schizophrenia

• Disorganized speech -:an inability to remain coherent, rambling to imagined people or voices, often termed "word salad".
• Grossly disorganized or catatonic behavior - decrease in awareness of immediate environment; a trance-like inactivity, mania, severe rigidity, or flexibility of the limbs.

Stigma of Schizophrenia

These symptoms plus the nasty side effects of treatment medications is trial enough, but those who earn this DSM label are also confronted with stigma and social alienation.

A 2011 Journal of Public Mental Health review titled "'Public Perceptions, Knowledge and Stigma Towards People with Schizophrenia," discussed common misconceptions which include that schizophrenia is a multiple personality disorder, that those afflicted are more violent, or that the disorder is caused by substance abuse or family upbringing. Removing the stigma attached to these debilitating disorders can in part be achieved by using the correct terms only to describe the disorder and not the individuals.

Dissociative Identity Disorder Defined:

"The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self)."

At least two of these identities repeatedly take over the person's behavior. There will be an inability to remember important personal information and the symptoms cannot be related to substance abuse or any medical condition. DID develops in early childhood as a means of coping with repeated trauma.

Understanding the difference between DID and schizophrenia and using the terms where appropriate is the first step in respecting both the individuals who have these diseases and removing the stigma associated with them.