Dissociative identity (multiple personality) disorder: more common than previously thought

Abstract

Dissociative symptoms are known to accompany many psychiatric disorders. This article reviews clinical, phenomenological and epidemiological data on the disorders and diagnostic and therapeutic recommendations in patients with dissociative identity disorder. Dissociative identity disorder (DID) is characterized by the formation of additional personalities, which take control over human behaviour. A disruption of identity is associated with a distinct discontinuity in the sense of self and a sense of will. This disruption is accompanied by changes in affective state, behaviour, consciousness, memory or perception. The etiology of this disorder is not fully understood, although many data indicate that the experience of severe trauma plays a major role. The goal of dissociation is to avoid the feeling of negative emotions in response to trauma. Data indicate also the contribution of genetic factors in the pathogenesis of the disease. The estimated incidence of personality dissociation disorders is about 1% in environmental studies, with a majority of women. Studies show that DID is not a rare disorder and its incidence can be compared to the incidence of schizophrenia in general population. Psychotherapy is the first-line treatment for dissociative disorders. Pharmacological treatment is recommended as adjunctive therapy, depending on the symptoms presented by a given patient. Many aspects of DID are still unexplored, although in the in literature DID was mentioned first time over one hundred years ago. Many psychiatrists still question the existence of dissociative identity disorders, others do not undertake diagnosing them.