The difference between schizophrenia and 'split personality'

1 Conversation

For years now, people, in the media and in my personal life, always think that having a 'split personality' is the same as schizophrenia. Well it is not and I get a bit frustrated every time I hear it. So, once and for all, I want to get rid of this misunderstanding.


"Schizophrenia is the label applied to a group of disorders characterized by severe personality disorganization, distortion of reality, and an inability to function in daily life."1

Typical for schizophrenia are the having of hallucinations (mostly visual and auditory hallucinations). To try to interpret these hallucinations, that are so real to him, the sufferer develops delusions. A well known delusion is that someone thinks he has magic power, given by God himself, or that he is God.

The state of having hallucinations and delusions is called psychotic. A psychosis affects the brain and damages it.

Also typical for schizophrenia are the disorders in emotional perception, movement (stiff movements) and speach (abruptly stop in the middle of a sentence and start another), which make the sufferer look bizar to others.

The most common form of schizophrenia is the schizophrenia paranoia. The thoughts get controlled by strong suspicious delusions and the hearing of voices (auditory hallucinations). In comparence with other forms of schizophrenia, the disorders in emotional perception, movement and speach are rather small.

The development of schizophrenia often starts during adolescence or young adulthood. It is believed that the cause of it, is one of a genetical matter that gets triggered by stress factors, like a depression or the death of a dear person or other experiences that are hard to cope with.

The prognosis of schizophrenia is bad when the disease developed slowly, when there were no significant factors to trigger it, when it started to develop early and when there are more family members suffering from schizophrenia. Considering that every psychosis damages the brain, it is good to avoid them as much as possible.

Good treatment therefore is the taking of medications to suppress a psychosis and joining psychotherapy during non-psychotic episodes to learn to live with the symptoms and avoid possible triggers for a psychosis (such as pressure, unstable and unhealthy life, stress, insecure feelings).

'Split personality'

A split personality has nothing to do with schizophrenia, but the more with Multiple Personality Syndrom (MPS). This is a psychiatric disorder at which the sufferer has divided his personality into subpersonalities, also known as alters.

The alters have their own memory and don't know of eachother's existence. The consequence is, that the sufferer has several episodes of amnesia.

Almost always the development of MPS is triggered by (sexual) abusion. During the traumatic experience the person dissociated ("not being here", a form of trance) and an alter took over the pain. For every traumatic experience an alter was created. The alternating of the alters (!!) is easily recognized by the changing of the voice of the sufferer.

MPS is one of the most severe forms of defense mechanisms, used by the psyche to cope with traumatic experiences.

Since 1994, MPS is officially classified as Dissociative Identity Disorder in the DSM-IV2 as the alters are more identities than personalities based on dissociations.

As MPS (or DID) is believed to be very rare, not much research has been done. Thereby there is not much known of the prognosis. It is said that the later the developing of the alters took place, the better. Another outcome of research is the fact "that after the age of 50, the alternating of the alters would spontaneously reduce."3

The experience learned that sufferers who had reintergrated alters cured better than sufferers with still divided alters.

The intergration of the alters was always accomplished by many years of intensive psychotherapy.


The explanations of schizophrenia and 'split personality' (or MPS/DID) show that there are many differences between the two. In practice this doesn't always show immediately. When taking a better, longer look at the sufferer and his symptoms, it gets clear what can be diagnosed. This is a normal kind of thing in the psychiatry.

Every person is different and all symptoms mentioned above can look different. It is normal that a person gets wrongly diagnosed in the start of treatment. As long as treatment fits the sufferer and the diagnosis gets adjusted along the way, there isn't a problem.

Although it is eventually often hard to recognize what kind of disease a person is suffering from, the differences between schizophrenia and MPS are rather different. I hope that I made that clear. From now on, it is forbidden to mix the two up!

To make it more difficult to do that, I'll end with a bit of history:

The term schizophrenia is from Bleuler (1911), who firstly identified more and milder varieties of the disease. He spoke of a "Gruppe der Schizophrenien" (group of schizophrenics). Schizophrenia is another word for......split mind!!

1'Introduction to Psychology',R.C.Atkinson,R.L.Atkinson,E.R.Hilgard. Harcourt Brace Jovanovich Inc., New York.2'Diagnostic and Statistical Manual - 4th. edition', most popular classificationsystem developed by the American Psychiatric Association in 1994.3'Handboek psychopathology, deel 1 (Handbook Psychopathology, part 1)', W.Vandereycken e.o. Bohn Stafleu Van Loghum, Houten/Zaventem, The Netherlands.

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