Published: February 27, 2025

Dissociative Identity Disorder vs Schizophrenia

Mental health issues are diverse and often they are comorbid. They impact the life quality of a patient and they bring trouble to their surroundings. Among all mental disorders, there are two which sound a bit frightening if you do not know details about them. Often, people even confuse them. These two mental illnesses are schizophrenia and dissociative identity disorder. Do they overlap, are they similar in their etiology and treatment? Which distinctive features show that a person has a split personality and which are characteristic of schizophrenia? This article gives answers to these questions.

Is Schizophrenia a Dissociative Disorder? Discovering Differences

Although both schizophrenia and DID refer to mental illnesses which disconnect a patient from reality, they are definitely not similar either in their roots or in their symptoms. First, how does the scientific community classify schizophrenia and multiple personality disorder? According to the 5th edition of DSM-5-TR [1], schizophrenia is a psychotic disorder. Its main features during the psychosis episode include disconnection with reality and hallucinations. The same source which is a guideline for US mental healthcare, assigns DID as a dissociative disorder (one of dissociative disorders). Dissociation refers more to mosaic personality which includes several separated identities.

Differences Between Schizophrenia and Dissociative Identity Disorder

So, the core difference between schizophrenia and split personality disorder is that the first impacts the only identity of a person and attacks the psyche with recurrent psychotic episodes while DID makes a person change their identities.

Schizophrenia-diagnosed patients still maintain their only identity and they understand their age, name, gender, and other personal information. Patients with DID can be one person one day, and totally another if the personality shift is triggered. Dissociative identity disorder provokes the development of a spectrum of identities (alters) with totally different biographies, names, genders, preferences, and life backgrounds in one person.

Similarities Shared By Schizophrenia and DID

Why are schizophrenia and multiple personality disorder often confused? The reason is their symptoms often overlap. Both patients with schizophrenia spectrum disorders and DID-diagnosed patients often feel out of their bodies, they have delusions and hallucinations, they hear voices in their heads ruling their lives, and they can experience memory loss, dissociation, and suicidal thoughts. Yet, these symptoms often differ.

Symptoms Schizophrenia vs Dissociative Disorder

So, which symptoms are decisive for diagnosing schizophrenia?

The first manifestation of schizophrenia typically happens between the ages of 16 and 30.
The symptoms of schizophrenia start slightly and grow severe.
Schizophrenia is a cyclic illness with psychotic episodes that last up to 6 months interchanging with periods of remission.
The core symptoms are loss of concentration, delusions, visual, and audial hallucinations, sleep disorders, lack of motivation, poor grooming, and disorganized cognitive functions.

For dissociative identity disorder, the symptoms are quite different:

The first signs of illness may manifest in early childhood (app at 6 years).
Patients suffer from delusions and hallucinations but they are not related to psychotic episodes.
Multiple separate identities develop in one body and they act differently, have different habits and even languages they speak.
Mood swings and sudden changes in preferences are typical for DID even in terms of one identity operating.
Memory lacunas and issues of amnesia happen to DID patients quite regularly as their memory and cognitive functions operate differently from norm-typical people.

Causes of Dissociative Disorder and Schizophrenia

If we compare schizophrenia vs multiple personality disorder according to their causes, the difference is also considerable.

The causes of schizophrenia are not 100% clear. Yet, scientists consider it to be a result of a combination of physical, genetic, psychological and environmental factors. [2] Typically, if predecessors of a person had been diagnosed with schizophrenia, the chances are high a person may have it too.

The first and foremost cause of DID is severe early childhood trauma the youngling’s psyche cannot cope with. Typically, this is emotional or sexual abuse-related trauma which occurred at the age of 2-6 years. Also, severe neglect and crime-related traumas can trigger DID.

Can someone have schizophrenia and multiple personality disorder?

The next thing to consider in the comparison of schizophrenia vs dissociative disorder is whether they are comorbid. As statistics say, schizophrenia is not typically accompanied by dissociative identity disorder. However recent studies revealed that from 9% to 50% of patients diagnosed with schizophrenia spectrum disorders also have unique symptoms of DID [3]. So, a patient may suffer from both these mental issues.

Treatments for Dissociative Identity Disorder and Schizophrenia

The treatment method for each of the mental issues we depict in this article also differs. Although both of them require a patient to stay in rehab during acute episodes, the therapy is not the same.

What treatment is offered for schizophrenia-diagnosed patients?

Medications are the pillars of schizophrenia treatment. Antipsychotics, antidepressants, sedatives, and mood stabilizers are a must to withdraw a patient from a state of psychosis and mitigate delusions and hallucinations. Besides, some medications can be used to remove side symptoms like migraines, concentrations and memory issues.
Electric brain stimulation is another method used for schizophrenia treatment. It includes a course of electroconvulsive therapy or cranial magnetic stimulation therapy to mitigate hallucinations as approximately 77% of patients positively respond to these methods [4].
Psychotherapy works as a supportive method in schizophrenia treatment. The best practices are CBT, cognitive adaptation training, and family therapy.

Unlike schizophrenia treatment based on medications, DID therapy is firstly based on psychotherapy. Its parts include:

Working with post-trauma
CBT methods to stabilize the psyche
DBT methods to merge a split personality
Family therapy for social support of a patient
Art therapy to fix the personality in a moment and prevent identity changes.

Medications are added to suppress the symptoms of depression and anxiety.

Thus, although schizophrenia and dissociative identity disorder have a couple of symptoms in common (namely, hallucinations, delusions, memory issues, trance states etc), they are not similar either in their etiology or in their impact on the patient’s well-being. Schizophrenia is a psychotic illness triggered by a combo of factors including genetic predisposition. DID is a post-traumatic response of a childish psyche which is a kind of abnormal coping strategy when the personality splits and creates false identities with separated thoughts, biological characteristics, beliefs, memories, and preferences. They are treated differently as schizophrenia is successfully treated by medications and physiotherapeutic methods while psychotherapy is a clue method for DID treatment.

At the same time, if you face the symptoms of both schizophrenia spectrum disorder or dissociative identity disorder in your loved ones or you experience them yourself, the remedy is here. URP Behavioral Health treatment center offers the best practices of experienced specialists to help you manage your mental health and return to your well-being. Just apply for a consultation to allow us to start your effective rehabilitation to reach a strong life-long remission.

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