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Say an individual was born with uncontrollable intermittent ESP. Rather than something fairly innocuous like seeing ghosts, his ESP sees things from beyond. He'll randomly pick up stimulus from a surreal, unpleasant, parallel universe that will interfere with his perception of his own reality. This is perceived like augmented reality rather than whole sensory substitution, with the alien sensations overlaid onto the real ones. He is unable to take care of himself because of the interference in normal perceptions: he might become disoriented by vertigo due to a second gravitational pull or distracted by sudden shrieks and walk into traffic, or fail to attend hygiene when the bathroom fills with foul-smelling slime.

Although the symptoms are dramatically different and effectively untreatable (how do you close an imaginary third eye?), would doctors diagnose such a condition as a form of schizophrenia? He probably needs a caretaker and a seeing eye dog if he isn't simply confined in an institution.

EDIT: I can provide more detailed explanation of symptoms if that makes it easier to model. The visual symptoms include objects that obscure his line of vision. Learning to navigate blindfolded doesn't help because all of the senses are affected, such as gravity and touch. A loud, continuous noise would render him unable to hear anything else until it stops. Repulsive odors would cause nausea and possibly vomiting.

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*According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5), to meet the criteria for diagnosis of schizophrenia, the patient must have experienced at least 2 of the following symptoms [1] :

Delusions

Hallucinations

Disorganized speech

Disorganized or catatonic behavior

Negative symptoms

At least 1 of the symptoms must be the presence of delusions, hallucinations, or disorganized speech.

Continuous signs of the disturbance must persist for at least 6 months, during which the patient must experience at least 1 month of active symptoms (or less if successfully treated), with social or occupational deterioration problems occurring over a significant amount of time. These problems must not be attributable to another condition.*

http://emedicine.medscape.com/article/288259-overview

Quite honestly - I'm not 100% certain and its all dependent on this person adaptability. Assuming that the person would be able to learn within while that his perception is not real and somehow more or less function - then according to diagnostic criteria it would be classified as not suffering from delusion and not suffering from negative symptoms of schizofrenia. Thus - it would be rather counted as schizophreniform disorder.

To be confined to an institution actually requires some level of effort. Assuming that person does not agree - is clear threat for himself or others? If not than actually can say no.

The fact that symptoms are untreatable would not be so simple. Given a chance doctors would try their luck with long list of typical and atypical antypsychotic (which may take clearly more than a year, such meds are quite unpredictable, so no one would notice anything unusual if first few failed). Under most of them the patient would anyway be much calmer, what may be counted as partial success (but at expense of quite nasty side effect). Antidepresant may make such person less stressed out and that would be actually worth their mild side effect.

You are putting here a let's say severe case - with whom the path would be quite clear. If the symptoms were moderate I see high chances of actually guy who with limited luck tries his luck as outpatient, but seeing medication failure and serious side effects gives them up and actually no one is able to force him to do otherwise.

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  • $\begingroup$ Actually, the character's adaptability or lack thereof does not effect the diagnosis of schizophrenia. If the person is experiencing what the rest of the world terms hallucinations on an ongoing basis, then that is grounds for diagnosis as schizophrenia. How the character adapts determines how well the person functions, but not the presence of the illness. $\endgroup$ – Thom Blair III Dec 26 '16 at 9:20
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    $\begingroup$ @ThomBlairIII This "adapts" would be influence whether the rest of the world would see enough symptoms of schizofrenia or not in such person. If not, than such person would fail (at least according to DSM-5) to get such diagnosis. And instead get “Unspecified Schizophrenia Spectrum Disorder”. $\endgroup$ – Shadow1024 Dec 26 '16 at 9:49
  • $\begingroup$ Yes, good point on the "spectrum" part. I forgot that. $\endgroup$ – Thom Blair III Dec 26 '16 at 13:35
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He probably would be diagnosed a having schizophrenia and have a seeing eye dog (or be locked up, depending on your society's culture). If more people with this condition are discovered it might be medically recognized and effort would be put into figuring out how it works, why some people have it and not others, what causes it, and lastly learning more about the world these people can see into. this may even cause a tech revolution, as it will inspire tech advances to figure these questions out

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Although treatment suggestions seem to be somewhat beyond of the scope of your question, and not knowing what direction you want to take your character, perhaps consider your statement that the character's "condition" is untreatable as more like it is not yet known the best way to treat these symptoms.

A less extreme condition that has similarities to what you describe, is termed "sensory processing disorder (SPD). SPD is not recognized by psychiatrists as a diagnosis, though they acknowledge that children do have problems based on over- or under-receptivity of their senses." https://childmind.org/article/treating-sensory-processing-issues/

This article also acknowledges "the seven (or eight) senses" which includes additional senses beyond the usual 5: motor-positional, spacial orientation and body organ information processing senses. These would be closely related to some of the sensory experiences your character is having trouble assimilating with his ESP functioning as well.

While severity is much more pronounced in your character, there could feasibly be healers in your story that would be willing to try non-drug approaches to your character's sensory "disorder" similar to those mentioned in the article. Depending on the level of success with an extreme case like this, they may choose to use a more appropriate diagnosis that acknowledges the cause of the symptoms, rather than just labels the evidence that the symptoms are present.

Since ESP sensing itself is still in the fringe category of study, this kind of diagnosis and treatment would be as well, but would that really matter to your story if it contributes to a cure, if that its the direction the story is heading?

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Yes, Diagnosis of Something in Schizophrenia Spectrum

If your character has any form of sensory perception that includes things that are not there according to the rest of the world, then the person is said to be hallucinating. According to psychiatrists, doctors and social workers I have talked to, there is only one mental illness in the DSM that entails ongoing hallucinations, and that is going to fall somewhere in the schizophrenia spectrum.

If your character can prove to doctors that he is not hallucinating, that he is genuinely experiencing ESP or clairvoyance, then that would prevent him from being diagnosed as delusional, but he would have to provide incontrovertible proof of psychic ability, which is something modern medicine wholeheartedly does not believe in.

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