This document defines and describes several dissociative disorders including dissociative identity disorder (previously called multiple personality disorder), dissociative amnesia, depersonalization/derealization disorder, and dissociative fugue. It provides diagnostic criteria and discusses treatments which generally involve psychotherapy and occasionally medication to help patients integrate their identities and recover memories. The goal of treatment is to help patients understand their condition and fuse their personalities into a single functioning identity.
This document defines and describes several dissociative disorders including dissociative identity disorder (previously called multiple personality disorder), dissociative amnesia, depersonalization/derealization disorder, and dissociative fugue. It provides diagnostic criteria and discusses treatments which generally involve psychotherapy and occasionally medication to help patients integrate their identities and recover memories. The goal of treatment is to help patients understand their condition and fuse their personalities into a single functioning identity.
This document defines and describes several dissociative disorders including dissociative identity disorder (previously called multiple personality disorder), dissociative amnesia, depersonalization/derealization disorder, and dissociative fugue. It provides diagnostic criteria and discusses treatments which generally involve psychotherapy and occasionally medication to help patients integrate their identities and recover memories. The goal of treatment is to help patients understand their condition and fuse their personalities into a single functioning identity.
MBBS KU FM Sudan Clinical MD Psychiatry SMSB Consultant Psychiatrist –Alfashir Teaching Hospital Assistant Professor of Psychiatry FU Definition characterized by a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior. It includes: Dissociative identity disorder Dissociative amnesia Depersonalization/derealization disorder Other specified dissociative disorder, Unspecified dissociative disorder. Dissociative Identity Disorder previously called multiple personality disorder Characterized by the presence of two or more distinct identities or personality states Personalities take control of the individual's behavior Accompanied by an inability to recall important personal information The identities or personality states, sometimes called alters, self-states, alter identities Diagnostic Criteria A. Disruption of identity characterized by two or more distinct personality states The disruption in identity involves marked discontinuity in sense of self accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory- motor functioning. These signs and symptoms may be observed by others or reported by the individual. B. Recurrent gaps in the recall of everyday events, important personal information and or traumatic events that are inconsistent with ordinary forgetting C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning D. The disturbance is not a normal part of a broadly accepted cultural or religious practice E. The symptoms are not due to the physiological effects of a substance Over 70% of outpatients with the diosorder have attempted suicide. Dissociative Amnesia an inability to recall important personal information, usually of a traumatic or stressful nature,it could be; localized –losses all memory within a period of time (most common) selective- remember some but not all
generalized- may forget identity
Continuous- unlike others there is not an end
Interference is primarily with episodic memory (ones
autobiographical memory) while semantic memory (facts) remains intact Diagnostic Criteria • A. An inability to recall important autobiographical information, usually of a traumatic or stressful nature, B. The symptoms cause clinically significant distress or
impairment in social, occupational functioning.
C. The disturbance is not attributable to the physiological
effects of a substance or a neurological or other medical
condition or other neurological condition). D. The disturbance is not better explained by dissociative
identity disorder, posttraumatic
stress disorder, acute stress disorder, somatic symptom disorder. Dissociative Fugue Forget personal details, identity, and flee to an entirely new location Tend to end abruptly Majority regain most of memories without a recurrence Must face consequences of their fugue Illegal or violent activity etc… Depersonalization/Dereallzation Disorder A. The presence of persistent or recurrent experiences of depersonalization ,derealization or both, 1. Depersonalization: Experiences of unreality, detachment, or being an outside observer with respect to one’s thoughts, feelings, sensations, body, or actions 2. Derealization: Experiences of unreality or detachment with respect to surroundings B. During the depersonalization or derealization experiences, reality testing remains intact. C. The symptoms cause clinically significant distress or impairment in social, occupational, functioning. D. The disturbance is not attributable to the physiological effects of a substance or another medical condition E. The disturbance is not better explained by another mental disorder Treatments for Dissociative Amnesia and Fugues Psychodynamic therapy Hypnotic therapy Drug therapy Sodium pentobarbital (“truth serums”). Medication decreases inhibitions making recall more likely but may forget again upon awake. All focus on uncovering memories Treatment of Dissociative Disorder Three Major Goals 1) Help recognize fully the nature of their disorder 2) Recover gaps in their memory 3) Integrate their personalities into one functioning personality Fusion- final merging of 2 or more alters Goal is integration Help each alter to understand they are part of one person Use alters names for convenience not to confirm existence of separate autonomy All alters should be treated with fairness Encourage empathy amongst the alters Gentleness and supportiveness are needed in consideration of childhood traumas