Schizophrenia, Bipolar Disorder, Multiple Personality: Objectively, Not Emotionally, Multiple Personality is the Least Controversial Psychiatric Diagnosis

Schizophrenia and Bipolar Disorder

For more than a hundred years—and now as much as ever—there has been a scientific controversy as to whether schizophrenia and bipolar disorder are, or are not, different diseases. The four main reasons for the controversy are:

1. genetics: studies show a large overlap for bipolar and schizophrenia.

2. medication: many of the same medicines are used to treat both.

3. heterogeneous symptoms: two persons diagnosed with schizophrenia may be quite different from each other; this may also be true of two persons diagnosed as bipolar.

4. overlap of symptoms: persons diagnosed with schizophrenia or bipolar disorder may have many of the same symptoms. This is sometimes such a problem that an intermediate diagnosis, schizoaffective disorder, is used.

Why, then, don’t news stories about schizophrenia begin: “In the latest study of schizophrenia, one of the most controversial diagnoses in psychiatry…”? The reason is that it is a controversy, about which, very few people get emotional.

Multiple Personality

In contrast to schizophrenia and bipolar disorder, the symptoms used to diagnose multiple personality are not found in any other psychiatric disorder.

And whereas schizophrenia and bipolar disorder have been recognized clinical entities, reported in the medical literature, for about a hundred years, multiple personality has been a recognized clinical entity, reported in the medical literature, for at least two hundred years.

This is not to say that what is now called schizophrenia and bipolar disorder did not always exist. They probably did—although some historians dispute that they did—but they had not been considered distinct diagnoses.

And this is not to say that multiple personality has only existed for two hundred years. Previously called demon or spirit possession, it had been known since antiquity.

“Controversial”

So the next time you hear multiple personality referred to as “the most controversial diagnosis in psychiatry,” you should think, “The most controversial? Compared to what?”

And you should be aware of how the word “controversy” is being used. It is being used to refer to the fact that the issue makes some people emotional.