MULTIPLE PERSONALITY. DISSOCIATION MECHANISM OPPOSITE TO SCHIZOPHRENIA
Keywords:Dissociative Identity Disorder, Splitting, Treatment, Psychoanalytical Approach, Schizophrenia
AbstractMotivation: identity disorder is a mental disorder with a major impact on all aspects of a person's life, affecting in many cases most of its functional areas. The patient in this case study is 40 years old and appears to have good functionality at work, but his personal life is affected. As co-morbid disorders, obsessive-compulsive disorder and substance use can be mentioned. On the other hand, making a differential diagnosis between identity disorder and schizophrenia is difficult for this patient, because he has symptoms with elements specific for both disorders. Objectives: This paper aims to assess the current profile and longitudinal dynamics of a identity disorder in the case of a 40-year-old patient. He was brought to the psychiatrist by his sister, who found some quirks in his brother's behavior and insisted that he consult a specialist to help him. Also, considering the stress-vulnerability model, the factors that contributed to the onset of the pathology will be captured. Simultaneously with the symptoms of this disorder, we will also consider the effects that substance use has on the patient's condition. Methods: Psychological evaluation, interview, case study, management of the therapeutic alliance and proposal of a long-term treatment, in the absence of which the symptoms may worsen, with the risk of significantly affecting functionality and even suicide. Results: The study outlines a profile based on the fragility of the ego and personal boundaries, going as far as the splitting of the ego, the patient declares that there are different people in it: "authority, accountant, good will", "Half of the things I say I hear for the first time"), the fragility of the boundaries of reality ("life is not reality", "to stay away from reality and stay in my mind for a while"), confusion between the material area and the immaterial one ("the bottom step of the safety pyramid", "I don't clean the house because it costs; at first it costs detergents and then it costs the mind to force itself to clean it too"), dissociation between body, mind and soul ("I speak with my desires", "the body was born first, I was born after; the desires are his"), chain of ideas and flight of thoughts, to which are added behaviors from the obsessive-compulsive spectrum (" mistakes are a kind of death "," I am not allowed to spend, not for me either ”,“ 10 pairs of socks. Do you have? We are not talking”)
Bliss, E. L. & Jeppsen, E. A. (1985). Prevalence Of Multiple Personality Among Inpatients And Outpatients. American Journal Of Psychiatry 142(2), 250–251. DOI: https://doi.org/10.1176/ajp.142.2.250
Braun, B. G. (2018). Psychotherapy of the Survivor of Incest With a Dissociative Disorder. Psychiatric Clinics of North America 12(2), 307–324. Retrieved from https://dx.doi.org/10.1016/s0193-953x(18)30433-7 10.1016/s0193-953x(18)30433-7 DOI: https://doi.org/10.1016/S0193-953X(18)30433-7
Brende, J. O. & Rinsley, D. B. (1981). A Case of Multiple Personality with Psychological Automatisms. Journal of the American Academy of Psychoanalysis 9(1), 129–151. Retrieved from https://dx.doi.org/10.1521/jaap.1.19126.96.36.199 10.1521/jaap.1.19188.8.131.52 DOI: https://doi.org/10.1521/jaap.1.19184.108.40.206
CORYELL, W. (1983). Multiple Personality and Primary Affective Disorder. The Journal of Nervous and Mental Disease 171(6), 388–390. Retrieved from https://dx.doi.org/10.1097/00005053-198306000-00011 10.1097/00005053-198306000-00011 DOI: https://doi.org/10.1097/00005053-198306000-00011
Kluft, R. P. (1985). Childhood Antecedents Of Multiple Personality. In Childhood Antecedents Of Multiple Personality. Washington, Dc: American Psychiatric Press
Ludwig, A. M., Brandsma, J. M., Wilbur, C. B. & Bendfeldt, F. (1972). The Objective Study Of A Multiple Personality. Or, Are Four Heads Better Than One? Archives Of General Psychiatry 26(4), 298–310. DOI: https://doi.org/10.1001/archpsyc.1972.01750220008002
Mcwilliams, N. (1994). Psychoanalytic Diagnosis. In Psychoanalytic Diagnosis. New York: The Guildford Press
Putnam, F. W., Guroff, J. J., Silberman, E. K. & Barban, L. (1986). The Clinical Phenomenology Of Multiple Personality Disorder: Review Of 100 Recent Cases. The Journal Of Clinical Psychiatry 47(6), 285–93.
Ross, C. A. (1997). Dissociative Identity Disorder: Diagnosis, Clinical Features, And Treatment Of Multiple Personality (2nd Ed.) In Dissociative Identity Disorder: Diagnosis, Clinical Features, And Treatment Of Multiple Personality. New York: John Wiley & Sons, Inc
Spiegel, D. (1984). Multiple Personality As A Post-Traumatic Stress Disorder. Psychiatric Clinics Of North America 7(1), 101–110. DOI: https://doi.org/10.1016/S0193-953X(18)30783-4
Trifu, S., Marica, S., Braileanu, D., Carp, E. G. & Gutt, A. M. (2015). Teaching Psychiatric Concepts of Neurosis, Psychosis and Borderline Pathology. Conceptual Boundaries. Procedia - Social and Behavioral Sciences 203, 125–129. Retrieved from https://dx.doi.org/10.1016/j.sbspro.2015.08.269 10.1016/j.sbspro.2015.08.269 DOI: https://doi.org/10.1016/j.sbspro.2015.08.269
Trifu, S., Tudor, A. & Radulescu, I. (2020). Aggressive behavior in psychiatric patients in relation to hormonal imbalance (Review) Experimental and Therapeutic Medicine 20, 3483–3487. Retrieved from https://dx.doi.org/10.3892/etm.2020.8974 10.3892/etm.2020.8974 DOI: https://doi.org/10.3892/etm.2020.8974
Trifu, S. & Trifu, A. D. (2020). Receptor Profiles Of Atypical Antipsychotic Molecules. University Politehnica Of Bucharest Scientific Bulletin Series B-Chemistry And Materials Science 82(1), 113–128.
Trifu, S., Vladuti, A. & Trifu, A. I. (2020). Genetic Aspects In Schizophrenia. Receptoral Theories. Metabolic Theories. Romanian Journal Of Morphology And Embryology 61(1), 25–32. DOI: https://doi.org/10.47162/RJME.61.1.03
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