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Mental Illnesses Confused with Schizophrenia

Learn about the mental illnesses that are often confused with schizophrenia from psychiatrist Jeanie Tse in this Howcast video.


Hi. I'm Jeanie Tse. I'm here to speak with you about mental illnesses that are often confused with schizophrenia. There are many different illnesses that can cause what we call psychotic symptoms. Those include delusions, feeling paranoid, that people are out to hurt you, or feeling grandiose, feeling that you are maybe more important then you are, that there's a mission to accomplish, or so forth, and hallucinations, where you hear or see things that people don't hear or see. Those things also occur in bipolar disorder and in major depression as well.

And maybe it's a bit artificial how we've divvied this up in psychiatry and in the diagnostic and statistical manual. But, basically, if you have primarily depressive moods, even if you hear voices as part of them or even if you feel paranoid as part of them, if it's a depression that comes and then goes, then that's actually depression, not schizophrenia.

If you have a depressed and a manic picture, where sometimes you have increased energy and don't sleep and are a bit reckless with your activity, and have voices and paranoia, then you may have bipolar disorder instead.

The thing that makes schizophrenia or schizoaffective disorder different than bipolar disorder or depression is actually that you have these delusions or hallucinations in the absence of any mood symptoms. Those things are often confused.

Sometimes, people will have one psychotic episode, comes out of the blue. They hear voices. They feel paranoid. And then it goes away. That's not schizophrenia. Just because you've had one brief psychotic episode does not mean that you're going to have schizophrenia and that this is going to be with you for the rest of your lift. In fact, what we also require to make the diagnosis is a gradual decline in functioning that occurs over a longer period of time.

In addition, there's been a lot of confusion because the name schizophrenia in Greek means split mind, that split personalities are involved in schizophrenia. In fact, that's totally not true. What we think about when we talk about split personalities, having a few different identities is actually called dissociative identity disorder, and it's also actually a fairly controversial diagnosis.

Sometimes, people confuse autism and schizophrenia as well. Autism is a developmental disorder where people have more difficulty with social skills and social awareness. And that can look a lot like schizophrenia. Some people with autism also have schizophrenia, but people with autism do not generally have all of the paranoia and hallucinations that someone with schizophrenia has.

When we are trying to determine if somebody has schizophrenia, we also need to rule out whether the psychotic symptoms, or the decline that we're seeing, are due to a mental illness only, or if they're actually due to a substance that the person is using. Things like amphetamines or LSD, phencyclidine which is angel dust, PCP, or sometimes even marijuana can mimic the symptoms of schizophrenia. So, we have to rule that out. And then, many medical conditions, especially ones that affect the brain, like lupus or Parkinson's disease or dementia, can look schizophrenia as well. So, we have to rule that out before we can make the diagnosis.

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