getting a diagnosis for DiD can be difficult
diagnosis and difficulties.
In the UK, getting a diagnosis for DID can be extremely difficult. The patient can spend between 5 and 12 years within the mental health system before a correct diagnosis is made.
Many psychiatric teams do not accept the existence of the diagnosis, having been taught that it is controversial and not supported by research.
This is clearly not true, however it can be difficult to shift this mindset, and patients who are chronically traumatised may fit many diagnostic categories.
Because of this they can be given several incorrect diagnosis such as
- Borderline personality disorder or Complex post-traumatic stress disorder
- Schizo-affective disorder
- Bipolar disorder
- Complex partial seizures
- Drug or alcohol addiction
- Eating disorders.
In the UK there is a lack of education within the NHS regarding dissociative disorders and trauma. Dissociative Identity Disorder is seen as either rare or non existant. The ICD, sees dissociative disorders as being on the whole acute (i.e. short-term), reactive, and transient responses to here-and-now traumatic experiences. Due to lack of awareness, and training the disorder is rarely recognised within the UK mental health system.
The DSM-5 provides the following criteria to diagnose dissociative identity disorder:
Two or more distinct identities or personality states are present, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.
Amnesia must occur, defined as gaps in the recall of everyday events, important personal information, and/or traumatic events.
The person must be distressed by the disorder or have trouble functioning in one or more major life areas because of the disorder.
The disturbance is not part of normal cultural or religious practices.
The symptoms can not be due to the direct physiological effects of a substance (such as blackouts or chaotic behaviour during alcohol intoxication) or a general medical condition (such as complex partial seizures).
‘The DSM-5 and the ICD-10 are both major manuals used within professional mental health for diagnosis’
DSM-5 – Diagnosic and Statistical Manual of Mental Disorders, 5th Edition
By American Psychiatric Association. (2015)
ICD -10 – The ICD -10 Classification of Mental and Behavioural Disorders:
Clinical Description and Diagnostic Guidelines. (1992 – WHO)
Both manuals view dissociative disorders somewhat differently. The DSM understands dissociative disorders as being chronic, long-term conditions that are developmental in nature—in order words, they develop over a period of time in response to trauma and attachment difficulties as a child’s brain grows and matures, and they therefore tend to persist over time too as they are more or less ‘hard-wired’ adaptations.
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