The 8 differences between psychotic and dissociative disorders

What are the differences between dissociative disorders and psychotic disorders? Let's take a look.

Do you know what are the main characteristics of psychotic disorders and of dissociative disorders? In this article, in addition to giving an answer to this, we will know the main differences between psychotic and dissociative disorders..

As we will see, these are two completely different types of mental disorders, and we will verify it from their characterization and the development of their corresponding differences.

Psychotic and dissociative disorders: what are they like?

Before delving into the differences between psychotic and dissociative disorders, let's see what each of them consists of (and what they are).

Psychotic disorders

Psychotic disorders are a type of severe mental disorder, in which strange or abnormal ideas and perceptions appear. There is usually also a loss of contact with reality; the "quintessential" psychotic symptoms are hallucinations and delusions, although there are more.

The DSM-5 (Statistical Manual of Mental Disorders) lists the following psychotic disorders:

• Schizophrenia
• Brief psychotic disorder
• Schizophreniform disorder
• Delusional disorder
• Schizoaffective disorder
• Psychotic disorder due to other medical conditions
• Substance-induced psychotic disorder
• Catatonia
• Other Specified Schizophrenia Spectrum Disorders
• Other unspecified schizophrenia spectrum disorders

Dissociative disorders

Dissociative disorders are those in which there are a loss of the integrative functions of memory, identity, perception, motor functions or consciousness..

Its characteristic symptom is an alteration in the organization or structure of the mental content (not so much an alteration of the content itself). Thus, there is a disconnection and a lack of continuity between memories, thoughts, actions, identity....

It is worth mentioning that dissociative phenomena do not always have to be pathologicalThere are dissociative phenomena that are not pathological.

In the DSM-5 we find the following dissociative disorders:

• Dissociative identity disorder.
• Dissociative amnesia
• Depersonalization/derealization disorder
• Other specified dissociative disorder
• Unspecified dissociative disorder

Major differences between psychotic and dissociative disorders

In this article we have collected the 8 main differences between psychotic and dissociative disorders, although there are more.

1. Main symptoms

The first of the differences between psychotic and dissociative disorders are their symptoms; as we have seen, these are two separate and distinct types of disorders, each with its own characteristics.

In psychotic disorders the main problem is one or more psychotic symptoms that involve a distorted perception of the present (hallucinations, delusions, delusions of (hallucinations, delusions, disorganized thinking...); on the other hand, in dissociative disorders, there are no psychotic symptoms, but their main symptom is a discontinuity (or interruption) between our identity, our memory, our behavior, etc.

So, as we see, the main symptoms in both disorders are totally different.

Nature of the symptoms

The nature of the symptoms is also diverse. Thus, psychotic disorders involve the appearance of one or more (psychotic) symptoms, establishing an incongruence between what the senses perceive and what the consciousness perceives; on the other hand, in dissociative disorders, there is a loss of a function (memory, identity, etc.) that functions in a limited way..

3. Contact with the reality/consciousness of the disorder

Another difference between psychotic and dissociative disorders has to do with contact with reality.

In psychotic disorders (e.g. schizophrenia) there is usually a loss of contact with immediate reality.in psychotic disorders (e.g. schizophrenia), but not in dissociative disorders.

Moreover, in psychotic disorders it is more frequent that the person is not aware of his or her affectation; on the other hand, in dissociative disorders, it is more frequent that the person is not aware of his or her affectation, in dissociative disorders, people are usually aware of their "losses".. For example, this is clearly seen in dissociative amnesia, where there is a significant loss of autobiographical memory.

4. Presence of cognitive disorders

In psychotic disorders Cognitive disorders or alterations may appear (and they frequently do).These symptoms appear, above all, in advanced stages of the disorder (especially in schizophrenia).

On the other hand, in dissociative disorders these symptoms are not characteristic (except for the loss of memory that occurs in dissociative amnesia or dissociative fugue, although it would be of a different nature).

5. Duration

We must be cautious in this aspect, since there are different disorders within psychotic and dissociative disorders, and each one has its own characteristics. However, the truth is that we can say that duration is another difference between psychotic and dissociative disorders.

In general, psychotic disorders tend to have a longer duration (some are even chronic disorders), whereas dissociative disorders tend to have a longer duration. (some are even chronic disorders), whereas dissociative disorders usually have a beginning and an end, i.e. a shorter duration, delimited in time (days, months...). Moreover, in the case of non-chronic psychotic disorders (e.g. brief psychotic disorder), their duration is usually longer than the duration of dissociative disorders.

But let us give examples. In the case of psychotic disorders, let's think of schizophrenia; it is chronic.. If we think, on the other hand, of substance-induced psychotic disorders, these are temporary and therefore their duration is shorter (also schizophreniform disorder, which lasts between one month and six months).

In the case of dissociative disorders, think of dissociative fugue or dissociative (psychogenic) amnesia; both disorders usually last from hours to months (more hours than months).

6. Degree of incapacitation

Another difference between psychotic and dissociative disorders is their degree of interference in daily life or the incapacitation they produce (remember that we always speak at a general level, and that each disorder should always be analyzed specifically). Psychotic disorders are usually more disabling than dissociative disorders..

7. Prevalence

The prevalence of psychotic disorders in general is not known exactly, but we do know their prevalence in the case of psychotic disorders. we do know their prevalence in the case of schizophrenia (0.3-0-7% of the population, according to the DSM-5) or schizoaffective disorder (0.3% according to DSM-5).

For its part, dissociation is estimated to occur in 2-3% of the general population.The dissociative disorders themselves, according to some studies (Loewenstein, 1994) have a prevalence of 10% in the population.

8. Causes

Another difference between psychotic and dissociative disorders has to do with their causes.

The causes of psychotic disorders are usually multifactorial (except in those induced by substances or other medical conditions). Thus, social, Biological and environmental factors are combined in their etiology, although the hereditary factor in psychotic disorders (especially in schizophrenia, where it is known that monozygotic twins have a 48% probability of suffering from both).

In the case of dissociative disorders, we also find multifactorial causes, although it is true that psychological traumas are usually at the basis of these disorders. frequently (sexual or physical abuse in childhood, witnessing or living through an accident, events involving death, etc.).

Psychotic disorders usually appear, rather than as a result of a trauma, following a highly stressful period, in addition to other etiological factors (biological or personal vulnerability, biological inheritance, etc.). On the other hand, dissociative disorders usually appear as a result of a trauma or a situation that the person feels as highly threatening or dangerous for him/her.