Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-18T08:17:58.072Z Has data issue: false hasContentIssue false

Dissociative Identity Disorder: diagnosis and treatment in the Netherlands

Published online by Cambridge University Press:  16 April 2020

H.N. Sno
Affiliation:
Department of Psychiatry, De Heel General Hospital, PO Box 210, 1500 Ee Zaandam, the Netherlands
H.F.A. Schalken
Affiliation:
University Department of Psychiatry, Academic Medical Center Amsterdam, the Netherlands
Get access

Summary

Dissociative Identity Disorder (DID) is a controversial diagnosis and empirical data on the efficacy of treatment modalities are scanty. The objective of this study was to explore the frequency of the diagnosis, the types and efficacy of prevailing treatment practices, and to examine demographic data on patients in the Netherlands.

A questionnaire, including questions on one selected DID patient, was mailed to 1,452 Dutch psychiatrists. The response rate was 46.7%. A total of 273 psychiatrists reported having made the diagnosis at least once. The diagnosis was made in a statistically significant manner more frequently by female psychiatrists, by psychiatrists aged 50 years or younger, and by those certified after 1982. No correlation was observed with primary theoretical orientation or the type or topography of work facility.

The mean age of the selected patients was 33.2 and the male:female (M:F) ratio 1:9. The majority of patients were seen once a week in an outpatient setting. Individual psychotherapy and adjunctive anxiolytic or antidepressant medications were the most widely endorsed treatment modalities. Hypnosis was rarely used.

We conclude that the diagnosis of DID is not to be dismissed as a local eccentricity. It is warranted as an explanatory framework in the context of a psychotherapeutic treatment.

Type
Original article
Copyright
Copyright © 1999 Éditions scientifiques et médicales Elsevier SAS.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-IV). Washington, DC: American Psychiatric Association; 1994.Google Scholar
Benson, FFMiller, BLSigner, SF. Dual personality associated with epilepsy. Arch Neurol 1986; 43: 471474.CrossRefGoogle ScholarPubMed
Boon, SDraijer, N. Multiple personality disorder in the Netherlands: a clinical investigation of 71 patients. Am J Psychiatry 1993; 150: 489494.Google ScholarPubMed
Braun, BG. Treatment of multiple personality disorder. Washington, DC: American Psychiatric Press; 1986.Google Scholar
Braun, BG. The use of naltrexone in the treatment of dissociative disorder patients.In: Braun, BG ed. Seventh international conference on multiple personality and dissociative states. Chicago: Rush University Department of Psychiatry; 1990. p. 20Google Scholar
Braun, BG. Unusual medication regimens in the treatment of dissociative disorder patients: part I. Noradrenergic agents. Dissociation 1990; 3: 144150.Google Scholar
Chodoff, P. More on multiple personality disorder [letter]. Am J Psychiatry 1987; 144: 124.CrossRefGoogle Scholar
Coons, PM. Treatment progress in 20 patients with multiple personality disorder. J Nerv Ment Dis 1986; 174: 715721.CrossRefGoogle ScholarPubMed
Crombag, HMerckelbach, H. Hervonden herinneringen en andere misverstanden. Amsterdam/Antwerpen: Uitgeverij contact; 1996.Google Scholar
Dell, PF. Professional skepticism about multiple personality. J Nerv Ment Dis 1988; 176: 528530.CrossRefGoogle ScholarPubMed
Drake, ME. Epilepsy and multiple personality: clinical and EEG findings in 15 cases. Epilepsia 1986; 27: 635.Google Scholar
Dunn, GEPaolo, AMRyan, JJVanFleet, JN. Belief in the existence of multiple personality disorder among psychologists and psychiatrists. J Clin Psychol 1994; 50: 454457.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
Fahy, TA. The diagnosis of multiple personality disorder: a critical review. Br J Psychiatry 1988; 153: 597606.CrossRefGoogle Scholar
Horevitz, R. Hypnosis in the treatment of multiple personality disorder.In: Rhue, JWLynn, SJKirsch, I eds. Handbook of clinical hypnosis. Washington, DC: American Psychiatric Association Press; 1993. p. 395CrossRefGoogle Scholar
Horevitz, RLoewenstein, RJThe rational treatment of multiple personality disorder.In: Lynn, SJRhue, JW eds. Dissociation: clinical and theoretical perspectives. New York: Guilford Press; 1994. p. 289316.Google Scholar
Hornstein, NLPutnam, FW. Clinical phenomenology of child and adolescent dissociative disorders. J Am Acad Child Adolesc Psychiatry 1992; 31: 10771085.CrossRefGoogle ScholarPubMed
Hutschemaekers, GVanDer Heuvel, HJacobs, C. Beroep: psychiater. Utrecht: NcGv; 1992.Google Scholar
Kluft, RP; The natural history of multiple personality disorder.In: Kluft, RP ed. Childhood antecedents of multiple personality. Washington, DC: American Psychiatric Press; 1985. p. 167196.Google Scholar
Kluft, RP. Multiple personality disorder.In: Tasman, AGoldfinger, SM eds. American psychiatric press review of psychiatry, vol 10. Washington, DC: American Psychiatric Press; 1991. p. 161188.Google Scholar
Kluft, RP. Hospital treatment of multiple personality disorder. Psychiatr Clin North Am 1991; 14: 695719.CrossRefGoogle ScholarPubMed
Loewenstein, RJ. Rational psychopharmacology in the treatment of multiple personality disorder. Psychiatr Clin North Am 1991; 14: 721740.CrossRefGoogle ScholarPubMed
Mai, FM. Psychiatrists'attitudes to multiple personality disorder: a questionnaire study. Can J Psychiatry 1995; 40: 154157.Google ScholarPubMed
Merskey, H. The manufacture of personalities: the production of multiple personality disorder. Br J Psychiatry 1992; 160: 327340.CrossRefGoogle ScholarPubMed
Modestin, J. Multiple personality disorder in Switzerland. Am J Psychiatry 1992; 149: 8892.Google ScholarPubMed
Olthuis, FH. Klinische behandeling van MPS: indicaties en voorwaarden. Tijdschrift voor Psychiatrie 1996; 38: 173184.Google Scholar
Piper, A. Treatment of multiple personality disorder: at what cost? Am J Psychother 1994; 48: 392400.CrossRefGoogle ScholarPubMed
Pope, HGOliva, PSHudson, JIBodkin, JAGruber, AJ. Attitudes toward DSM-IV dissociative disorders diagnoses among board-certified American psychiatrists. Am J Psychiatry 1999; 156: 321323.Google ScholarPubMed
Putnam, FLoewenstein, RJ. Treatment of multiple personality disorder: a survey of current practices. Am J Psychiatry 1993; 150: 10481052.Google ScholarPubMed
Putnam, FWGuroff, JJSilberman, EBarban, LPost, RM. The clinical phenomenology of multiple personality disorder: review of 100 recent cases. J Clin Psychiatry 1986; 47: 285293.Google ScholarPubMed
Putnam, FW. Diagnosis and treatment multiple personality disorder. New York/London: Guilford Press; 1989.Google Scholar
Riley, RLMead, J. The development of symptoms of multiple personality disorder in a child of three. Dissociation 1988; 1: 4146.Google Scholar
Ross, CA. Dissociative identity disorder: diagnosis, clinical features, and treatment of multiple personality. New York: John Wiley and Sons; 1997.Google Scholar
Stendhal ‘Le Rouge et le Noir’: chronique du XIXe siècle. Paris: Editions Gallimard; 1830. p. 552.Google Scholar
Torem, MS. Psychopharmacology.In: Michelson, LKRay, WJ eds. Handbook of dissociation: theoretical, empirical and clinical perspectives. New York: Plenum Press; 1996.Google Scholar
Zwartjes, GC. Psychobiologische aspecten van dissociatie en posttraumatische stress-stoornis.In: Jonker, KDerksen, JJLDonker, FJS eds. Dissociatie: een fenomeen opnieuw belicht. Houten: Bohn Stafleu van Loghum; 1995.Google Scholar
Submit a response

Comments

No Comments have been published for this article.