Year : 2013 | Volume
: 55 | Issue : 4 | Page : 403--404
Dissociative identity disorder: An uncommon psychiatric disorder reported
Siva Shankar Priya, Nambi Siva
Department of Psychiatry, Sree Balaji Medical College and Hospital, Chrompet, Chennai, Tamil Nadu, India
Siva Shankar Priya
Department of Psychiatry, Sree Balaji Medical College and Hospital, Chrompet, Chennai, Tamil Nadu
|How to cite this article:|
Priya SS, Siva N. Dissociative identity disorder: An uncommon psychiatric disorder reported.Indian J Psychiatry 2013;55:403-404
|How to cite this URL:|
Priya SS, Siva N. Dissociative identity disorder: An uncommon psychiatric disorder reported. Indian J Psychiatry [serial online] 2013 [cited 2020 Jan 18 ];55:403-404
Available from: http://www.indianjpsychiatry.org/text.asp?2013/55/4/403/120565
Dissociative Identity Disorder (DID) is an enigmatic disorder in psychiatry, with a prevalence of around 0.1-1%. It has been often wrongly diagnosed as schizophrenia, bipolar affective disorder, impulse control disorder, or borderline personality disorder among others. We are presenting one such case.
Ms. M, a nineteen year old college going girl was brought for consultation by her mother for repeated attacks of amnesia and poor impulse control related symptoms like irritability, destructive behaviour and self harm.
On further enquiry, the patient gave a history of being accused of lying and being hypocritical since she was in the sixth grade; having no memory of how she landed up in unexpected places (a nearby zoo/friend's place); having a sense of being estranged, hearing voices in her head of her mother talking with other people. Her mother gave a history of being able to see 3 different states in her daughter- a nineteen year old intelligent college student; a trusting state in which she speaks in a childish voice and having high risk behaviour (like going off with strangers, taking drinks mixed with intoxicants, not recognizing treating doctors); and an aggressive state in which she is easily irritable, paces about and attempts to harm her mother or herself. She (patient) herself is unaware of these episodes and states.
On admission, organicity was ruled out by appropriate tests. She was put on a mood stabilizer and anti depressive agents for symptomatic control. Safety and security was established. The patient narrated her abuse (during adolescence) in one of the other dissociative states.
This could have been misdiagnosed as psychosis, intermittent explosive disorder, depressive disorder, or borderline personality disorder. The keen observation by the mother (who herself had possession syndrome and depression earlier in life) helped in the diagnosis. A treating clinician must be aware and be on the lookout for dissociative states and be prepared for therapeutic work with such patients.