Dissociative identity disorder
The content of the article:
- Causes and risk factors
- Forms of the disease
- Symptoms
- Features of the course of the disease in children
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
Dissociative identity disorder (split personality, multiple personality disorder, multiple personality disorder) is a rare mental disorder, one of the dissociative disorders, manifested by the presence of two or more personalities in the patient, alternating with each other. These personalities are often called identities, ego states, alter personalities.
Dissociative identity disorder - the presence of two or more personalities in a person, alternating with each other
Causes and risk factors
The most common cause of the development of dissociative personality disorder is severe stress experienced in childhood, caused by emotional, sexual or physical abuse, neglect, death of parents, serious illness and other factors.
In children, the formation of a single integral personality normally occurs under the influence of personal life experience and many factors. If at this stage the child is under the influence of prolonged excessive stress, then he does not have a combination of various mental components (emotions, memories, perception, life experience) into an integral personality. Each new stress experienced by a child, each new phase of development that takes place in unfavorable conditions, can cause the formation of a new identity, that is, personality.
Forms of the disease
Dissociative identity disorder is classified into two types depending on its clinical presentation:
- Possessed form. Alter personalities manifest as a spirit, supernatural being, or other external force that takes control of the patient and forces him to perform uncharacteristic acts. An alter-personality arises regardless of the patient's desires, gives him severe discomfort, and in some cases creates more serious problems.
- Uncontained form. Patients become bystanders of their own actions, emotions, speech. This form of pathology is often combined with the phenomena of periodic dissociative amnesia.
Symptoms
In the clinical picture of dissociative identity disorder, several leading symptoms are distinguished:
- Multiple identities. With an obsessed form of the disease, patients periodically behave in an unusual, strange way, as if another person or some creature had possessed them. This strangeness is usually clearly visible to others. In an uncontrolled form, changes in patient behavior are usually subtle to those around them. However, the patients themselves experience a feeling of depersonalization (detachment in relation to their own mental and physical processes, a feeling of unreality of what is happening to them). Often they say that at such moments they feel like a person of the opposite sex or a small child.
- Dissociative amnesia. It is manifested by the disappearance of some time periods from memory. For example, patients cannot remember when and where they bought a particular item, or they cannot explain the meaning of the notes they made earlier. A distinctive feature of dissociative amnesia is that patients forget not only traumatic or stressful events, but also everyday ones.
- Hallucinatory syndrome. Auditory, gustatory, olfactory, tactile and visual hallucinations are frequent.
Dissociative identity disorder is characterized by amnesia when the person cannot remember a specific time period
In addition, the following pathological conditions are quite often observed:
- suicidal behavior;
- non-epileptic seizures;
- sexual dysfunction;
- self-mutilation, self-harm;
- substance abuse;
- depression;
- increased anxiety.
Features of the course of the disease in children
Symptoms of Dissociative Identity Disorder in Children:
- picky tastes;
- different manner of speaking;
- talking to oneself;
- auditory hallucinations;
- memory losses;
- aggressive behavior;
- inability to explain their actions and actions;
- "Glass" look.
A child's imaginary friend may be indicative of dissociative identity disorder or other mental illness
In childhood, the presence of a fictitious friend in a child or a pronounced passion for play does not always indicate dissociative identity disorder. This can be a symptom of another mental illness, or a variant of the norm.
Diagnostics
Diagnosis of dissociative identity disorder is based on the DSM-5 criteria (Diagnostic and Statistical Manual of Mental Disorders, 5th edition):
- the patient has two or more identities or personality states;
- recurring memory lapses related to events that a person normally never forgets (important personal information, everyday or traumatic events);
- the presence of other symptoms that bring significant discomfort to the professional and social aspects of the patient's life.
DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) criteria help diagnose dissociative identity disorder
Dissociative identity disorder requires differential diagnosis with a number of other disorders:
- traumatic brain injury;
- complex partial seizures;
- stress post-traumatic disorder;
- another type of dissociative disorder;
- alcoholic or drug intoxication.
It is also necessary to distinguish dissociative identity disorder from play (in childhood), certain religious or cultural practices.
Treatment
The main treatment for dissociative identity disorder is personality integration psychotherapy. It allows you to stabilize the condition of patients, improve their quality of life.
Drug therapy is carried out in order to relieve the manifestations of increased anxiety, depression, impulsivity.
Psychotherapy is the main treatment for dissociative identity disorder
In some cases, it becomes necessary to hospitalize patients in order to ensure constant round-the-clock monitoring of their condition.
Possible complications and consequences
The most common complications of dissociative identity disorder are:
- persistent headaches;
- sleep disorders (nightmares, sleepwalking, insomnia);
- problems in family life and professional activity;
- the development of a number of somatic diseases (peptic ulcer of the stomach and duodenum, bronchial asthma);
- alcoholism, drug addiction;
- disorders of sexual function;
- depression;
- suicide attempts.
Forecast
Dissociative identity disorder has a cyclical course in which the manifestations of the disease either subside or worsen. The therapy should be carried out for a long time, but in many patients it does not lead to a lasting positive result, but only helps to reduce the manifestations of social and professional discomfort.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
