Dissociative identity disorder - etiology, symptoms, treatment

Abstract

Introduction. According to the DSM-5, Dissociative Identity Disorder (DID) is identified as the existence of two or more distinct identity states, causing abrupt changes in self-awareness. These distinct identities are recognized to vary in sensory awareness, perceptual tendencies, emotional tone, emotional regulation, memory processes, thinking patterns, and behavioral responses. Aim of study. Gaining a thorough understanding and enhancing awareness about this disorder needs a comprehensive exploration of its etiological factors, clinical manifestations, and treatment options. Methods and materials. To achieve the study’s aim, PubMed and Google Scholar were utilized, the most relevant articles were selected. A total of 319 articles were found using the keywords „Dissociative identity disorder”. Results. DID emerges as a defensive response to traumatic experiences, giving rise to multiple identities with distinct memory access. Childhood traumas disrupt the ongoing development of a cohesive self, resulting in a fragmented identity as a defense against emotional and physical pain. Additionally, media influences, such as movies, books, and therapists’ expectations, contribute to its information. DID syndrome include various dissociative symptoms, including amnesia, conversion symptoms, voices, depersonalization, trance states, derealization, presence of other personalities, identity confusion, flashbacks, auditory and visual hallucinations, first rank Schneiderian symptoms, and experiences of somatic passivity. Notably, there are no evidence-based treatment guidelines for DID. However, the International Society for the Study of Trauma and Dissociation recommends psychodynamic psychotherapy, consisting of three phases: I- ensuring safety and stabilizing symptoms; II- focusing on trauma treatment; III- integrating identity. Conclusion. DID is a disorder insufficiently researched, especially in the Republic of Moldova, with childhood trauma being a significant etiological factor. It manifests through various dissociative symptoms, emphasizing its complex nature. Currently, there is no specific treatment, but psychodynamic psychotherapy is recommended.