Dissociative identity disorder and schizophrenia: Differential diagnosis and theoretical issues

Abstract

Schizophrenia and dissociative identity disorder (DID) are typically thought of as unrelated syndromes--a genetically based psychotic disorder versus a trauma-based dissociative disorder--and are categorized as such by the DSM-IV. However, substantial data exist to document the elevated occurrence of psychotic symptoms in DID; awareness of these features is necessary to prevent diagnostic confusion. Recent research has also pointed out that schizophrenia and DID overlap not only in psychotic symptoms but also in terms of traumatic antecedents, leading to a number of suggestions for revision of our clinical, theoretical, and nosologic understanding of the relationship between these two disorders.

Consciousness, awareness of insight and neural mechanisms of schizophrenia

“…In addition, there is a body of evidence showing overlap between mechanisms underlying dissociative symptoms and schizophrenia as proposed by Bleuler. Following Janet's definition of dissociation, Bleuler described that the process of splitting in schizophrenia is the same as splitting of psychic connections in hysteria and can lead to manifestations of alter personalities and typical amnesia (Janet, 1890;Bleuler and Brill, 1924;van der Hart and Friedman, 1989;Bob, 2003;Foote and Park, 2008;Moskowitz, 2008). In this context, a high prevalence of trauma history found both in schizophrenia (Read et al, 2005;van Os and Kapur, 2009) and dissociative identity disorder has been documented in recent studies (Spiegel, 1997;Kihlstrom, 2005).…”

Dissociative Disorder in a Patient with Schizophrenia

“…[7] However Schizophrenia and dissociative disorders share several common symptoms such as aberrant perceptual experiences and disruptions in reality testing and studies have shown considerable confusion in the diagnosis of Schizophrenia and Dissociative Disorders based on the presence of Schneiderian first rank symptoms that are present in both the disorders. They include auditory hallucinations, delusional thinking and thought insertion/withdrawal.…”

Reliability and Validity of the Dissociative Experiences Scale Among South Korean Patients With Schizophrenia

“…This is especially true at the very acute stage of schizophrenic illness with florid positive symptoms and confusion. After this period, we were able to show good psychometric properties of the DES and to infer that it may not be a problem of the psychological instrument per se, but a failure of current descriptive and categorical diagnostic nomenclature and limitation of medical philosophy of bio-genetic model of schizophrenic illness (Foote & Park, 2008).…”