Schizophrenia and Multiple Personality Disorder - Common Mistake

            The other day I was doing a class on behavior analysis for the staff of several care homes. One of the staff members approached me afterwards and wanted to talk about a particular patient he was working with. He started talking about the patient having multiple personality disorder saying he was diagnosed with Schizophrenia.

Schizophrenia and multiple personality disorder (Dissociative Identity Disorder) are two completely different diagnoses. Having worked in the field of psychology for more years than I care to mention (10 years specifically with schizophrenic patients), I have found that confusing these two for the same diagnosis is the most common mistake when talking to others about mental illness.  

Unfortunately, I have seen this in literature as well. I have read several books that included main characters (generally the bad guy) diagnosed as schizophrenic, but was actually described as having multiple personality disorder. Whenever I find mistakes like that in a book, it bothers me. I feel like the author based his/her knowledge on stereotypes and misinformation rather that doing research to make an accurate portrayal of someone with mental illness.  I know that not everyone who reads about fictional characters is going to be a professional in psychology, but I think it’s important to your homework if you are going to create a character with a mental illness.

            Schizophrenia is a Psychotic Disorder marked by hallucinations, delusions, and/or disorganized thinking. People with schizophrenia have both positive and negative symptoms. Positive symptoms include the hallucinations and delusions (including possible paranoia). They often hear voices and can sometimes be observed talking to themselves. The negative symptoms include mood, language, and motivation issues (including poor hygiene, odd emotional responses, and isolation). Schizophrenia is biologically based and is treated with a combination of antipsychotic medications and behavior management. The exact cause is unknown, but it is thought to have something to do with dopamine and possibly serotonin. Currently, there is no cure. People diagnosed with Schizophrenia are also often diagnosed with or suffer from symptoms of depression and/or anxiety as well. Substance abuse and suicide rates are higher than average in this population.

            Multiple personality disorder (Dissociative Identity Disorder) is a Dissociative Disorder (which also includes amnesia) and is caused by some extreme trauma like ritualistic sexual or physical abuse. To deal with the trauma, separate and distinct personalities are formed. Some symptoms may include headaches, severe memory loss, flashbacks, mood swings, unexplainable phobias, and depression among others. The treatment usually consists of long term therapy to deal with the trauma and integrate the personalities. This particular diagnosis has been surrounded by controversy for some time as to whether or not the condition actually exists. Several famous case studies were made into movies: Sybil and The Three Faces of Eve.

            So where do you get information on mental illness? If you are serious about it, invest in a Diagnostic and Statistical Manual IV (fourth edition). It is the diagnostic manual used by clinicians. It includes the clinical code, name, and diagnostic criteria for each condition. They cost around $100.00 new, but I have seen them on Amazon in decent condition for $10 - $15. Talk to people who work with mentally ill patients. Most cities have mental health services that have educational information available to the public about mental illness. Also, I wouldn’t normally recommend this, but actually Wikipedia had a pretty decent explanation of both of these disorders when I looked. I looked because the staff member I was talking to said he got his misinformation from Wikipedia, so I wanted to check and was surprised by the accuracy of the descriptions I found there.

            So remember, when creating a character with a mental illness…do your homework!