Psychopathy and Schizophrenia | Private Therapy Clinic
Saturday, 24 Feb 2018

What’s the difference between psychopathy and schizophrenia?

By Private Therapy Clinic

Psychopathy and schizophrenia are both frequently represented in popular culture—in thrillers and on TV shows—and they are both significantly more common among men than women, with the result that they are often confused and conflated. However, psychopathy and schizophrenia are two very different conditions.

Someone with schizophrenia typically suffers hallucinations whereby they are sure they see or hear something or someone that is not really there. They can often find it very diffiWhat's the difference between psychopathy and schizophrenia?cult to distinguish between these hallucinations and reality and, as a result, they can develop false beliefs and confused thinking, and can act in strange and unpredictable ways. Often, their delusions can be frightening and threatening, and people with schizophrenia can experience the world as a very scary place, in which they struggle to function normally, often neglecting to attend to their hygiene when they are unwell, and finding it difficult to sustain a normal conversation. Schizophrenia is a serious mental illness, probably due to both genetic and environmental factors, that is typically treated with anti-psychotic drugs.  Undiagnosed schizophrenics often “self-medicate” with alcohol and other legal and illegal substances. The condition often initially manifests in young adulthood, and persists throughout the patient’s life, sometimes requiring periods of hospital treatment during particularly serious episodes. The popular notion of someone with schizophrenia as having a “split personality” or “multiple personalities” is false.

Psychopathy (which is often considered to be the same thing as sociopathy) is an untreatable disorder that is manifested in a small percentage of the population. A psychopath is a person who does not experience empathy, typically does not feel remorse, is often antisocial, and can have an egoistic, exaggerated view of their own value and capacity. People with psychopathy are not delusional, although they typically find it very difficult to see things from others’ points of view.  It can be a difficult condition to diagnose, as psychopaths are often good at presenting as normal, and frequently do not self-identify as having a problem requiring support or help. They may react in a hostile or angry fashion to the suggestion that they require psychiatric help. Psychopathy cannot be treated with medication, and therapy introduces the risk that the psychopath may simply become better at manipulating others. However, it is certainly not a given that all psychopaths will become involved in criminal activities and, while they are disproportionately likely to be involved in instigating violence, they are also disproportionately likely to themselves die violently or in an accident. The key traits they often display—boldness, disinhibition, and meanness—can actually be useful in a range of professional contexts. While they are over-represented in serial killer populations, for example, they can also be highly successful in the worlds of business, the military, or politics, and often don’t ever commit any crimes at all if they can find a way to legally channel their personal qualities.

While popular culture does a great deal to inform the public about issues such as mental illness and addiction, unfortunately it often gets a lot wrong! To understand the complex conditions under discussion here, it’s important to read reliable sources and talk to the professionals.


For help with psychopathy and schizophrenia speak to one of our therapists here at Private Therapy Clinic for a free initial chat or to make an appointment.

  • General
  • Personality Disorders
  • Psychosis

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