SEMINAR PRESENTATION GUIDANCE Mrs. Shobha k. Jayanna HOD, Dept. of Microbiology PRESENTED BY Ramanuj Goswami M.Sc. Microbiology

CONTENTS INTRODUCTION HISTORY A SELF-TEST SINGS & SYMPTOMS CAUSES DIAGNOSIS TREATMENT EPIDEMIOLOGY CONCLUSION MULTIPLE PERSONALITY DISORDER

INTRODUCTION Multiple personality disorder- MPD Dissociative identity disorder-DID  One of the dissociative disorder.  MPD or DID- a condition in which “two or more distinct identities or personality states”.  DID as defined by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders(DSM).

HISTORY  DID is a controversial diagnosis and condition, generated and published in North America.  Hypnosis, which was pioneered in the late 1700s by Franz Mesmer and Armand-Marie, observed second personalities emerging during hypnosis.  Between 1880 and 1920, many great international medical conferences devoted his own theory in dissociation.  The controversial nature of dissociation hypothesis is shown quite clearly by the manner in which the American Psychiatric Association’s DSM. The second edition of DSM referred to this diagnostic profile as multiple personality disorder. The third edition grouped MPD in with four major dissociative disorders.

 Some people have the experience of driving a car and suddenly realizing that they don’t remember what happened during all or part of the trip. 0% 100% 0% 100%  Some people find that sometimes they are listening to someone talk and they suddenly realize that they did not hear part or all of what was just said. 0% 100%  Some people find that they have no memory for some important events in their lives (e.g. a wedding or graduation). 0% 100%

 Some people have the experience of finding themselves dressed in clothes that they don’t remember putting on.  Some people sometimes have the experience of feeling that other people, objects, and the world around them are not real. O% 100% 0% 100%

SYMPTOMS Normal dissociation DID or MPD Amnesia Depersonalization Derealization Identity disturbances

AMNESIA:-Loss of memory that is not due to ordinary forgetfulness. Caused by head injuries, brain diseases, epilepsy or dissociation. DEPERSONALIZATION:-A dissociative symptom in which the patient feels that his or her body is unreal, is changing or dissolving. DEREALIZATION:- A dissociative symptom in which the external environment is perceive as unreal. IDENTITY DISTURBANCES:-The patient’s having split off entire personality or characteristics and memories.

 UNSPEAKABLE CHILDHOOD ABUSE(97%). Several sexual, physical or psychological trauma in childhood.  An innate ability to dissociate easily.  Brain injury and epilepsy.  Interaction of overwhelming stress. ***DID may run in families; however, the genetic transmission question is unresolved.

Two or more distinct identity or personality states. Inability to recall important personal information. The disturbance is not due to the direct physiological effects of a substance or a general medical condition. Diagnosis should be performed by psychiatrist or psychologist- specially designed interviews and personality assessment tools. Screening test- DISSOCIATIVE EXPERIENCES SCALE(DES). a) Dissociative Disorder Interview Schedule(DDIS). b) Structural Clinical Interview for DSM-IV Dissociative Disorder(SCID-D). c) Hypnotic Induction Profile(HIP).

DES is a simple quick and validated questionnaire that has been widely used to screen for dissociative symptoms.  Structural clinical interview.  Used in the group with high DES score.  There is also DES scale for children. DDIS is a highly structured interview.  DDIS can usually be administered in 30-45min. SCID-D takes about 30-90min depending on the subjects experiences. **Many DID patients are misdiagnosed, include schizophrenia, borderline personality disorder, somatization disorder and panic disorder.

 Treatment of DID may last for five to seven years in adult and usually requires several different treatment methods. i. Psychotherapy ii. Medication iii. Hypnosis iv. Alternative treatment v. Prognosis

Psychotherapy:- Psychotherapy has several stages- →Uncovering and “mapping” the patients alters. →Treating the traumatic memories and “fusing” the alters. →Consolidating the patient’s newly integrated personality. Medications:- Tranquilizers or antidepressants for DID patients. Hypnosis:- While not always necessary, a standard method. →to recover repressed ideas and memories. →to control problematic behaviors. Alternative treatment:-Help to relax the body for did patients. →HYDROTHERAPY →THERAPEUTIC MASSAGE →YOGA

Prognosis:-

INDIA 0.015% SWITZERLAND % CHINA 0.4% GERMANY 0.09% NETHERLANDS 2% U.S 6-10% TURKEY 14% CANADA 1% The possible explanation for the increase of DID was-  Misdiagnosed as schizophrenia, bipolar disorder.  Another child sexual abuse. The DSM does not provide an estimate of incidence; however the number of diagnosis of this condition has risen sharply.

RECENT SURVEY RESULT BETWEEN- Dec 2- Dec 22, 2008 Description of current mental state as it related to experience(s) to rape and sexual abuse. Percentage of participants who have struggled with or continue to struggled with, self herm. Suicide Attempts or Suicidal Thoughts Only as They Relate to Experience(s) of Rape or Sexual Abuse. Percentage of Participants Reporting Serious Psychological Issues Caused by, or Worsened by, Experience(s) of Rape or Sexual Abuse - Self-Diagnosed or Professionally Diagnosed.

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