Boon S, Draijer N
Department of Psychiatry, Free University, Amsterdam, The Netherlands.
Am J Psychiatry. 1993 Mar;150(3):489-94. doi: 10.1176/ajp.150.3.489.
The aim of this study was to describe the phenomenology of multiple personality disorder as presented in a group of Dutch patients.
Seventy-one patients with multiple personality disorder were interviewed with the Dutch version of the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D); following the SCID-D, the Structured Trauma Interview was administered. Before the interview, patients completed the Dissociative Experiences Scale.
The presenting characteristics of the patients showed a striking resemblance to those in several large North American series. Patients had spent an average of 8.2 years in the mental health system prior to correct diagnosis. Patients presented with many different symptoms and frequently received other psychiatric or neurological diagnoses. A history of childhood physical and/or sexual abuse was reported by 94.4% of the subjects, and 80.6% met criteria for posttraumatic stress disorder.
Patients with multiple personality disorder have a stable set of core symptoms throughout North America as well as in Europe. To improve the detection of patients at high risk for multiple personality disorder, standardized instruments for inquiry about dissociative pathology should be used as part of routine diagnostic assessment.
本研究旨在描述一组荷兰患者所呈现出的多重人格障碍的现象学特征。
采用荷兰语版的《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）解离性障碍结构化临床访谈量表（SCID-D）对71例多重人格障碍患者进行访谈；在完成SCID-D访谈后，进行结构化创伤访谈。在访谈前，患者需完成解离体验量表。
这些患者的呈现特征与北美几个大型系列研究中的患者表现出惊人的相似性。在正确诊断之前，患者在心理健康系统中平均花费了8.2年时间。患者表现出许多不同的症状，并且经常被诊断为其他精神或神经疾病。94.4%的受试者报告有童年身体和/或性虐待史，80.6%符合创伤后应激障碍的标准。
在北美以及欧洲，多重人格障碍患者具有一组稳定的核心症状。为了提高对多重人格障碍高危患者的检测，应将用于询问解离性病理的标准化工具作为常规诊断评估的一部分。
