Dissociation or psychosis?: What is the difference and what impact do these different diagnoses have on treatment?
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This is a modified systematic literature review of addressing the question dissociation or psychosis? What is the difference and what impact do these psychopathologies have on treatment? The purpose of the study is to examine the two conditions of Dissociative Identity Disorder (intially known as Multiple Personality Disorder) and schizophrenia (previously termed dementia praecox) in order to provide a greater understanding and awareness of how each is both distinct from and similar to each other and so diminsh the possiblity of confusion, misdiagnosis and unsuitable treatment paths. The literature on schizophrenia and DID is extensive and there are many conflicting academic opinions; some theories suggesting that the conditions are distinct while others that they may be synonymous. This review examines the debates around these issues and provides an understanding of how the historical view of mental illness has influenced modern day perceptions. Symptomatology relating to the conditions is outlined, highlighting the complexity in client presentation, trauma issues and shared features between DID and schizophrenia. Differences and other significant influences underlying diagnostic issues are also presented. The underlying reasons why a diagnosis of schizophrenia often precedes that of DID, are also examined. The aetiology of both conditions is then described, particularly the controversial aspects relating to the causes of DID. Finally implications for practice from this review are considered with the intention of increasing awareness around the multi-factorial issues relating to these two conditions that often results in differential, delayed or no diagnosis. This increased awareness also has the potential to enhance the relationships between client, whanau (family), community and health professionals.