Atilan Fedai Ülker, Asoğlu Mehmet
Department of Psychiatry, Harran University Faculty of Medicine, Şanlıurfa, Turkey.
Neuropsychiatr Dis Treat. 2022 Dec 28;18:3035-3044. doi: 10.2147/NDT.S386648. eCollection 2022.
The prevalence of dissociative identity disorder (DID) is 1%. However, the diagnosis can be made less frequently. This rate is similar to that of schizophrenia, and it is a public health problem that should receive attention. In the wake of the research results and clinical experiences, it was determined that DID diagnosis was challenging. Despite prevalence rates being similar to those seen in schizophrenia, DID remains under-researched. This study aims to determine the sociodemographic features, complaints, aetiological traumas, comorbid psychiatric disorders, and previous psychiatric applications of patients who had DID diagnosis, as well as to increase the awareness and recognisability of DID.
Seventy patients who were diagnosed with DID based on the DSM 5 criteria and admitted to the outpatient clinic of the Department of Psychiatry Harran University Faculty of Medicine agreed to participate in this study. Patients filled out dissociative experiences scale, dissociation scale, and sociodemographic data form.
Of the 70 patients, 47 (67.14%) were female, and 23 (32.85%) were male. The mean age was 26.5 ± 9.63, the age range was 18-62. It was the first psychiatric application for 34 (48.57%) patients. Of the 70 patients, 27 (38.57%) had four or more applications. Only 17 patients (24.28%) had the sole diagnosis of DID, while 47 patients (67.14%) had comorbid depressive symptoms. Regarding the first complaints, 35 patients (50.00%) had dissociative symptoms; 49 patients (70.00%) had depressive symptoms. As for the trauma types, 45 patients (64.28%) had histories of physical abuse, while 34 patients (48.57%) had histories of chronic neglect.
The symptoms of DID can be related to many psychiatric disorders. DID patients can be classified under many different symptom groups. Treatments for symptoms fail when the diagnosis of DID is neglected. Patients are generally misdiagnosed, as determined in this study and in previous studies. Dissociative symptoms should be checked regularly during psychiatric interviews to prevent misdiagnosis.
分离性身份障碍（DID）的患病率为1%。然而，其诊断频率可能较低。这一患病率与精神分裂症相似，是一个应予以关注的公共卫生问题。基于研究结果和临床经验，发现DID的诊断具有挑战性。尽管其患病率与精神分裂症相似，但DID的研究仍不充分。本研究旨在确定被诊断为DID的患者的社会人口学特征、主诉、病因性创伤、共病精神障碍以及既往精神科就诊情况，同时提高对DID的认识和识别能力。
70例根据《精神疾病诊断与统计手册》第5版（DSM 5）标准被诊断为DID并入住哈兰大学医学院精神科门诊的患者同意参与本研究。患者填写分离体验量表、解离量表和社会人口学数据表。
70例患者中，47例（67.14%）为女性，23例（32.85%）为男性。平均年龄为26.5±9.63岁，年龄范围为18 - 62岁。34例（48.57%）患者是首次进行精神科就诊。70例患者中，27例（38.57%）有过4次或更多次就诊。仅17例患者（24.28%）被单独诊断为DID，而47例患者（67.14%）伴有抑郁症状。关于首发主诉，35例患者（50.00%）有分离症状；49例患者（70.00%）有抑郁症状。至于创伤类型，45例患者（64.28%）有身体虐待史，34例患者（48.57%）有长期忽视史。
DID的症状可能与多种精神障碍相关。DID患者可归为许多不同的症状组。当忽视DID的诊断时，针对症状的治疗往往失败。正如本研究及既往研究所示，患者通常会被误诊。在精神科访谈中应定期检查分离症状以防止误诊。
