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Hospital treatment of multiple personality disorder. An overview.

MPD patients are not rare. They frequently need hospital treatment. This brief and necessarily incomplete communication has attempted to share what is generally known and accepted with regard to their inpatient care. Such knowledge, however, even though it represents the current state of the art, is, like all state-of-the art knowledge, preliminary with regard to what remains to be discovered and developed. It is anticipated that within the next decade the increasing recognition of such patients will result in their becoming commonplace within most psychiatric hospital settings, drawing the attention of more and more hospitals and psychiatrists alike to the study of their care. At that point, the concentrated attention and endeavors of large numbers of skilled mental health professionals and administrators will, in all likelihood, bring fresh insights and offer new approaches that will enrich and perhaps supplant the observations and advices offered in this contribution.

Combined Modality Therapy↗

Rational psychopharmacology in the treatment of multiple personality disorder.

The current state of the data concerned with psychopharmacologic interventions for multiple personality disorder (MPD) is reviewed. Common sense guidelines are provided for drug treatment of MPD. An overview is given for use of medications for specific symptoms commonly found in MPD patients, such as affective, posttraumatic stress disorder, and sleep disorder symptoms.

Combined Modality Therapy↗

Psychotherapy of the survivor of incest with a dissociative disorder.

The treatment of the survivor of incest who suffers from a dissociative disorder is probably somewhat more difficult than that of other survivors of incest because for these others the material is more readily available. Also the patient with DD was probably more severely abused or the dissociative defense would not have been needed. This too makes therapy difficult, especially in that most necessary step: the development of trust and rapport. Despite these problems, there is a very good chance for a successful therapy that will bring the dissociated material back into the main stream of consciousness with a "here and now" appropriate perspective. This can be accomplished through proper diagnosis, good theoretics grounding, and therapy including psychotherapy with appropriate limit setting and the judicious use of medication. This article presents a summary of the BASK model of dissociation and two other models and gives ideas on how these models may be applied to the understanding of the etiology of dissociative disorders and their treatment. Case examples are used to illustrate successful treatment. Although treatment of incest survivors with dissociative disorders is difficult, success can be anticipated, and the rewards to the patient and the satisfaction for the therapist are great.

Adolescent↗

Unsuspected multiple personality disorder: an uncommon source of protracted resistance, interruption, and failure in psychoanalysis.

Multiple personality disorder (MPD) is being recognized with increasing frequency. A great imitator, it may be encountered among patients who appear to have a wide range of other diagnoses, and have been in treatment for years without the presence of MPD being discovered. Nine of 241 MPD patients interviewed by the author, 3.7%, had been accepted for psychoanalysis. In only one case had the diagnosis been appreciated by the analyst prior to his accepting the patient for analytic treatment. Four patients were profoundly resistant and or inaccessible to analysis for protracted periods. In one of these cases the diagnosis became clear and successful analysis was concluded, but three analyses ended unsuccessfully with the diagnosis still unknown. Two patients' analyses were interrupted due to abrupt regressive events initially perceived to indicate severe ego weakness incompatible with sustaining an analytic process, but later appreciated as signs of MPD. In three cases it appeared that the patients' being accepted for analysis triggered the emergence of the dissociative process, and either the patient or the analyst decided to pursue a different form of therapy. Unsuspected MPD appears to account for a small percentage of stalemates, failures, interruptions, and early flights from analysis.

Adult↗

The clinical phenomenology of multiple personality disorder: review of 100 recent cases.

The clinical syndrome of multiple personality disorder (MPD) is an unusual dissociative condition that has been poorly characterized. In an attempt to better delineate the clinical phenomenology of MPD, 100 recent cases were collected on a 386-item questionnaire completed by clinicians involved in the treatment of MPD patients. This study documents the existence of a clinical syndrome characterized by a core of depressive and dissociative symptoms and a childhood history of significant trauma, primarily child abuse.

Acting Out↗

Interictal behavior disorders in epilepsy.

Psychiatric symptomatology is present in many epileptics and some is directly or indirectly related to the seizure activity. Interictal and chronic psychiatric problems are particularly troublesome; awareness of the symptom clusters may lead to better diagnosis and treatment of these problems.

Aggression↗

Towards a theory of multiple personality and other dissociative phenomena.

That dissociation and multiple personality occur has been well documented. In this article the guest editor asks the following question: Are they created? To arrive at an answer he brings together various concepts under the rubric of state-dependent learning and presents ideas about how the states come together psychologically, physiologically, neurophysiologically, and physically.

Adrenocorticotropic Hormone↗

The differential diagnosis of multiple personality. A comprehensive review.

This review offers guidelines for the diagnosis of multiple personality disorder and other dissociative disorders and presents diagnostic criteria for psychotic disorders, factitious disorders, affective disorders, anxiety disorders, psychosexual disorders, and others that may or may not coexist with multiple personalities.

Adult↗

Spontaneous hypnotic age regression: case report.

Age regression--reliving the past as though it were occurring in the present, with age appropriate vocabulary, mental content, and affect--can occur with instruction in highly hypnotizable individuals, but has rarely been reported to occur spontaneously, especially as a primary symptom. The psychiatric presentation and treatment of a 16-year-old girl with spontaneous age regressions accessible and controllable with hypnosis and psychotherapy are described. Areas of overlap and divergence between this patient's symptoms and those found in patients with hysterical fugue and multiple personality syndrome are also discussed.

Adolescent↗

Multiple personality as a post-traumatic stress disorder.

This article examines multiple or dissociative personality syndrome as a multiple post-traumatic stress disorder, discussing these patient's developmental histories, their high hypnotizability, and their profound capacity to dissociate spontaneously to protect themselves from emotional and physical pain.

Adolescent↗

Are multiple personalities borderline? An analysis of 33 cases.

The authors detail their investigation into the positive relationship between borderline personality and multiple personality and present their finding that although borderline personality disorder is very prevalent in patients with multiple personality disorder, it is not universal and is a separate and distinct disorder.

Adult↗