How do you diagnose multiple personality disorder?!
Question: How do you diagnose multiple personality disorder.?
Answers:
The diagnosis of DID is complex and some physicians believe it is often missed, while others feel it is over-diagnosed. Patients have been known to have been treated under a variety of other psychiatric diagnoses for a long time before being re-diagnosed with DID. The average DID patient is in the mental health care system for six to seven years before being diagnosed as a person with DID. Many DID patients are misdiagnosed as depressed because the primary or "core" personality is subdued and withdrawn, particularly in female patients. However, some core personalities, or alters, may genuinely be depressed, and may benefit from antidepressant medications. One reason misdiagnoses are common is because DID patients may truly meet the criteria for panic disorder or somatization disorder.
Misdiagnoses include schizophrenia, borderline personality disorder, and, as noted, somatization disorder and panic disorder. DID patients are often frightened by their dissociative experiences, which can include losing awareness of hours or even days of time, meeting people who claim to know them by another name, or feeling "out of body." Persons with the disorder may go to emergency rooms or clinics because they fear they are going insane.
When a doctor is evaluating a patient for DID, he or she will first rule out physical conditions that sometimes produce amnesia, depersonalization, or derealization. These conditions include head injuries; brain disease, especially seizure disorders; side effects from medications; substance abuse or intoxication; AIDS dementia complex; or recent periods of extreme physical stress and sleeplessness. In some cases, the doctor may give the patient an electroencephalograph (EEG) to exclude epilepsy or other seizure disorders. The physician also must consider whether the patient is malingering and/or offering fictitious complaints.
If the patient appears to be physically normal, the doctor will next rule out psychotic disturbances, including schizophrenia. Many patients with DID are misdiagnosed as schizophrenic because they may "hear" their alters "talking" inside their heads. If the doctor suspects DID, he or she can use a screening test called the Dissociative Experiences Scale (DES). If the patient has a high score on this test, he or she can be evaluated further with the Dissociative Disorders Interview Schedule (DDIS) or the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). The doctor may also use the Hypnotic Induction Profile (HIP) or a similar test of the patient's hypnotizability.
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Misdiagnoses include schizophrenia, borderline personality disorder, and, as noted, somatization disorder and panic disorder. DID patients are often frightened by their dissociative experiences, which can include losing awareness of hours or even days of time, meeting people who claim to know them by another name, or feeling "out of body." Persons with the disorder may go to emergency rooms or clinics because they fear they are going insane.
When a doctor is evaluating a patient for DID, he or she will first rule out physical conditions that sometimes produce amnesia, depersonalization, or derealization. These conditions include head injuries; brain disease, especially seizure disorders; side effects from medications; substance abuse or intoxication; AIDS dementia complex; or recent periods of extreme physical stress and sleeplessness. In some cases, the doctor may give the patient an electroencephalograph (EEG) to exclude epilepsy or other seizure disorders. The physician also must consider whether the patient is malingering and/or offering fictitious complaints.
If the patient appears to be physically normal, the doctor will next rule out psychotic disturbances, including schizophrenia. Many patients with DID are misdiagnosed as schizophrenic because they may "hear" their alters "talking" inside their heads. If the doctor suspects DID, he or she can use a screening test called the Dissociative Experiences Scale (DES). If the patient has a high score on this test, he or she can be evaluated further with the Dissociative Disorders Interview Schedule (DDIS) or the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). The doctor may also use the Hypnotic Induction Profile (HIP) or a similar test of the patient's hypnotizability.
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