Dissociative Identity Disorder (Multiple Personalities)
Einstein Health Glossary
ICD 10 - F44
What is Dissociative Identity Disorder?
Dissociative Identity Disorder, as classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), was previously known as Multiple Personality Disorder. It is characterized by the presence of two or more identities or personality states.
These identities or personality states differ in how each one presents itself. Each identity maintains a “pattern” of perception, relationship, and thinking.
The phenomenon is characterized by an unconscious mechanism involving the segregation of a group of mental processes or behaviors from the rest of the person’s psychic activity. Thus, in this disorder, there is a disruption of one or more mental functions, such as memory, identity, perception, consciousness, and/or motor behavior, for example.
Incidence
Data on incidence is scarce. However, studies show a pattern of five women to one man and/or nine women for each man diagnosed with the disorder.
Causes
The disorder may be linked to traumatic experiences in childhood, with abuse being the main cause. Among adults diagnosed with the disorder, about 95% report childhood trauma. Physical and sexual abuse are also possible causes—such reports are frequent among patients. There is no evidence of genetic factors in its origin (so far).
Diagnosis
Presence of two or more distinct personality states. However, other symptoms are also present, such as avoidance (social inhibition, feelings of inferiority, inadequacy, etc.), numbness, somatic and conversion symptoms, depressive mood, mood instability, and obsessive-compulsive symptoms.
Children and adolescents may exhibit the same symptoms, with differences related to age and lifestyle. Often, only through reports from close adults is it possible to identify the disorder.
Treatment
The main approach is psychotherapy, including cognitive-behavioral therapy. The use of medication (serotonergic drugs) may be important in managing depressive symptoms and mood stabilization. Studies also highlight the importance of family therapy, group therapy, and occupational therapy.
The prognosis is poor among untreated patients. They tend to deteriorate and become involved in violent or antisocial situations and, in more severe cases, suicide.