Akyüz G, Doğan O, Sar V, Yargiç L I, Tutkun H
Department of Psychiatry, Cumhuriyet University Medical Faculty, Sivas, Turkey.
Compr Psychiatry. 1999 Mar-Apr;40(2):151-9. doi: 10.1016/s0010-440x(99)90120-7.
This study attempted to determine the prevalence of dissociative identity disorder in the general population. The Dissociative Experiences Scale (DES) was administered to 994 subjects in 500 homes who constituted a representative sample of the population of Sivas City, Turkey. The mean DES score was 6.7+/-6.1 (mean +/- SD). Of the 62 respondents who scored above 17 on the DES, 32 (51.6%) could be contacted during the second phase of the study. They were matched for age and gender with a group of respondents who scored below 10 on the scale, and the Dissociative Disorders Interview Schedule (DDIS) was then administered to both groups. Seventeen subjects (1.7%) received a diagnosis of dissociative disorder according to the structured interview. In the third phase, eight of 17 subjects who had a dissociative disorder on the structured interview could be contacted for a clinical evaluation. They were matched with a nondissociative control group and interviewed by a clinician blind to the structured interview diagnosis. Four of eight subjects were diagnosed clinically with dissociative identity disorder, yielding a minimum prevalence of 0.4%. Dissociative identity disorder is not rare in the general population. Self-rating instruments and structured interviews can be used successfully for screening these cases. Our data, derived from a population with no public awareness about dissociative identity disorder and no exposure to systematic psychotherapy, suggest that dissociative identity disorder cannot be considered simply an iatrogenic artifact, a culture-bound syndrome, or a phenomenon induced by media influences.
本研究试图确定普通人群中分离性身份障碍的患病率。对土耳其锡瓦斯市具有代表性的500户家庭中的994名受试者施行了分离体验量表（DES）。DES平均得分为6.7±6.1（均值±标准差）。在DES得分高于17分的62名受访者中，在研究的第二阶段能够联系上32人（51.6%）。将他们与量表得分低于10分的一组受访者按年龄和性别进行匹配，然后对两组施行了分离性障碍访谈量表（DDIS）。根据结构化访谈，17名受试者（1.7%）被诊断为分离性障碍。在第三阶段，结构化访谈诊断为分离性障碍的17名受试者中有8人能够联系上以进行临床评估。将他们与非分离性对照组进行匹配，并由对结构化访谈诊断不知情的一名临床医生进行访谈。8名受试者中有4人经临床诊断为分离性身份障碍，最低患病率为0.4%。分离性身份障碍在普通人群中并不罕见。自评工具和结构化访谈可成功用于筛查这些病例。我们的数据来自对分离性身份障碍没有公众意识且未接受过系统心理治疗的人群，这表明分离性身份障碍不能仅仅被视为医源性产物、文化相关综合征或媒体影响所致的现象。
