The name schizophrenia comes from two Greek terms: schizo (split) and phrene (mind). The disease is characterized by mental confusion and fragmented thinking. When the Swiss psychiatrist Eugen Bleuler coined this term, he probably meant “the split in the patient’s perception of reality.”

• In most healthy individuals, the mind and emotion are orientated to the past, present, and future. This uninterrupted mental environment appears to be disrupted in psychosis associated with schizophrenia.

• Because the dissociation or splitting of thoughts and emotions are hallmarks of schizophrenia, it gets the popular term “split mind” although it is not the correct term.

Schizophrenia should not be confused with dissociative identity disorder, which is commonly known as split personality or multiple personality disorder. The etiology and treatment of both these conditions are different.

In schizophrenia, the person loses touch with reality, so there is a split or dissociation between what they perceive and what the reality is.

Why is dissociative identity disorder confused with schizophrenia?

The main reasons why people confuse dissociative identity disorder (DID) with schizophrenia include:
• Certain symptoms overlap in both conditions.
• “Dissociation” from reality is misinterpreted by many as the presence of multiple personalities.
• The popular culture portrayals in novels and films lead people to believe that every hallucinating patient has schizophrenia.

However, DID often originates as a coping mechanism to an extremely traumatic episode in childhood, whereas schizophrenia is more likely to be genetic in origin with additional environmental factors at play.

The following symptoms may overlap in DID and schizophrenia confusing diagnosis:
• Hallucinations (both visual and auditory)
• Memory issues (false memories and lapse of memory)
• Mood swings
• Delusions
• Difficulties sleeping
• Suicidal ideation

Do people with schizophrenia hear voices?

Hearing voices inside one’s head is often the hallmark of schizophrenia (although not exclusive to it). These are called auditory hallucinations and are very distressing to the patient. About 80 percent of patients with schizophrenia either “hear voices” speaking to them or about them without anyone being there.

These hallucinations often begin in adolescence and young adulthood and “sound” very real to patients. These may grow so strong that they compel the patient into suicidal or violent actions.

Studies report that patients with schizophrenia who experience such auditory hallucinations have an abnormal representation of sound frequencies (abnormal tonotopic organization) in the auditory cortex (the part of the brain that processes sound). This abnormal pattern is often established in utero (while in the womb), which points to the genetic predisposition for the disease.

What diseases can be mistaken for schizophrenia?

Because the disease is marked with acute psychotic episodes and periods of remission, schizophrenia may often be mistaken for other diseases. Additionally, there are no specific diagnostic tests for schizophrenia, and by and large, the diagnosis remains clinical.

The following diseases may be mistaken for schizophrenia:

• Schizoaffective disorder: Although individuals with schizoaffective disorder have the same symptoms as those with schizophrenia, they additionally have episodes of depression and/or elevated mood (mania).

• Schizotypal personality disorder: A person with a schizotypal personality disorder often exhibits unusual behavior (eccentric; does not have close relationships) and has learning difficulties. They do not hallucinate, but they often develop a significant distrust of others, which many may interpret as delusions.

• Delusional disorder: People with delusional disorder often have a paranoid tendency. They believe in things that could happen but are unlikely. For example, a person with a delusional disorder may believe they have cancer despite several negative test results.

• Schizophreniform disorder: People with schizophreniform disorder have the symptoms of schizophrenia, but the episodes do not last as long (from one to six months), and they are better oriented to time, place, and person.