The Diagnostic Odyssey of Dissociative Identity Disorder: A Case Report of Prolonged Misrecognition

分离性身份障碍的诊断历程:一例长期误诊的病例报告

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Abstract

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.

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