Lim Enoch Chi Ngai, Lim Chi Eung Danforn
Research and Development, Specialist Medical Services Group, Earlwood, AUS.
National Institute of Complementary Medicine (NICM) Health Research Institute, Western Sydney University, Sydney, AUS.
Cureus. 2025 Jun 18;17(6):e86278. doi: 10.7759/cureus.86278. eCollection 2025 Jun.
Dissociative identity disorder (DID) is characterised by two or more distinct personality states, often resulting from severe childhood trauma. The disorder is frequently misdiagnosed as depression, anxiety, or borderline personality disorder. This case study is regarding a 28-year-old Caucasian woman with mental health challenges since primary school, including a bullying and domestic violence history, who received multiple incorrect diagnoses (depression, anxiety, panic disorder) given by various psychiatrists, psychologists and general practitioners over several years. Patient treatment with tricyclic antidepressants, selective serotonin reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors failed to produce any improvements. At age 16, a specialist general practitioner considered the former diagnoses were incorrect and recognised the need for multidisciplinary assessment, leading to referral to a specific psychiatry diagnostic service at a tertiary teaching hospital, where she was correctly diagnosed with DID. Psychologists with a special interest in DID provided the patient with intensive psychotherapy sessions. Her 12-year journey through therapy resulted in significant mental health recovery in addition to finishing her university degree and obtaining a job. This case highlights the importance of recognising DID, challenges in differential diagnosis, and the need for specialised multidisciplinary care.
分离性身份障碍（DID）的特征是存在两种或更多不同的人格状态，通常由童年时期的严重创伤所致。该障碍常被误诊为抑郁症、焦虑症或边缘性人格障碍。本案例研究的对象是一名28岁的白人女性，自小学起就有心理健康问题，包括曾遭受欺凌和家庭暴力，多年来，多位精神科医生、心理学家和全科医生对她做出了多种错误诊断（抑郁症、焦虑症、惊恐障碍）。患者使用三环类抗抑郁药、选择性5-羟色胺再摄取抑制剂和5-羟色胺-去甲肾上腺素再摄取抑制剂进行治疗均未见改善。16岁时，一位专科全科医生认为之前的诊断有误，并认识到需要进行多学科评估，于是将她转诊至一家三级教学医院的特定精神科诊断服务部门，在那里她被正确诊断为分离性身份障碍。对分离性身份障碍有特殊兴趣的心理学家为患者提供了强化心理治疗课程。她长达12年的治疗历程不仅使她的心理健康状况得到显著恢复，还让她完成了大学学业并找到了工作。本案例凸显了识别分离性身份障碍的重要性、鉴别诊断中的挑战以及专门多学科护理的必要性。
