The dissociative disorders are characterized by a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior.

We present the case of a 22-year-old patient, who has been following up for just over a year. The patient refers that two people inhabit her body, talk to each other, exchange opinions and both have control over the body, one giving the turn to the other depending on the circumstances. To this is added delusional symptoms of grandeur and sensorial-perceptual symptoms. In turn, depressive symptoms have appeared that have led the patient to have several suicide attempts throughout the follow-up time.

During this time, the patient has required hospital admission on two occasions due to the autolytic ideation. Treatment with neuroleptics and antidepressants has been established that have helped control delusions and thoughts of death, but not the dissociative clinic.

Dissociative Identity disorder 300.14 (F44.81)

The different symptoms presented by the patient, as well as the social and occupational deterioration that he presents, make this an extremely complicated case, both in diagnosis and in treatment. Dissociative identity disorder has been very controversial, changing its diagnostic criteria over time. More studies are needed and perhaps future research can give us more clues about this disorder.

No significant relationships.

Dissociative identity disorder(DID) is characterized by the existence of two or more distinct identities which involve changes in consciousness, emotion, memory, and behavior. It is associated with childhood traumatic experiences and other psychiatric disorders. Comorbidity in DID can lead to complex clinical presentations, poor treatment responses. Thus, it is crucial to identify patients with comorbidity and take them into the treatment plan.

We aim to report a case of DID and Attention-Deficit/Hyperactivity Disorder(ADHD) comorbidity.

A case report is presented alongside a review of the relevant literature regarding “dissociative identity disorder” and “attention deficit hyperactivity disorder”.

We describe the case of a 39-year-old woman with DID, onsetting at age 25, who had consistently responded poorly to long-term psychotherapy and pharmacological treatment. She presented with anxiety, distinct personality states, alterations in memory, consciousness and behavior problems in functioning, and high Dissociative Experiences Scale(DES) scores. Throughout the interviews, we noticed that she had limited attention, excess movements. After a detailed evaluation, diagnosis of ADHD is established, using the Diagnostic Interview for ADHD(DIVA) and ADHD Self-Reporting Scale(ASRS). Methylphenidate was prescribed in addition to previous medication. İmprovement in the severity of both ADHD and DID symptoms was presented with lower scores in DES and ASRS after the introduction of methylphenidate with progressive dose adjusting till 60mg/day.

Although previous studies demonstrated ADHD symptoms are related to dissociation, there is no well-established strategy for this. We believe that this case report provides a better approach to the comorbidity of ADHD and DID.

No significant relationships.

One of the central debates in the psychiatric community is the difficulty in distinguishing Dissociative Identity Disorder (DID) from Borderline Personality Disorder (BPD). The fact that core symptoms of these pathologies such as emotional dysregulation, alterations in sense of Self, amnesia, depersonalization, self harm, hearing voices, difficulties in maintaining relationships, are symptoms that feature in both disorders can lead physicians to a misdiagnosis, thus depriving patients with DID of adequate treatment.

To report a complex clinical case of a DID patient initially misdiagnosed as BPD.

Clinical case report.

A 45-year-old Caucasian woman with a history of childhood intrafamilial sexual abuse and domestic violence, substance use disorder, autolesionistic and suicidal behaviour with an active diagnosis of BPD presented to our ambulatory mental health care service. A more thorough examination revealed a history of emotional and affect dysregulation, depersonalization, amnesia, intrusive traumatic memories and nightmares with affective, cognitive, and sensorimotor aspects, persistent negative Self-perception. Auditory verbal hallucinations were also present described as inner space with commentary and derogatory nature with one of them being a child voice. The diagnosis of tertiary structural dissociation and DID was finally made when three Apparently Normal Personalities emerged with several Emotional Personalities, authorising for cautious partial pharmacological washout and initiation of three phase-orientated treatment approach.

DID is more common than is assumed and the overlap of core symptoms with other disorders can lead to a misdiagnosis. A careful clinical interview and evaluation of symptoms is mandatory to a correct DID diagnosis with a consequent appropriate therapy.

No significant relationships.

Dissociative identity disorder is a quite popular psychiatric diagnosis in general public but in actuality has a very low prevalence rate. Dissociative identity disorders are characterized by disruption of identity characterized by two or more distinct personality states with its own memories, behaviour, and preferences.

Authors present a case report about a patient of Dissociative identity disorder with Elektra complex as unconscious conflict.

A case report along with literature review forms the basis of discussion.

Mrs A, 30 years female, a housewife, belonging to low socioeconomic status, reported to the OPD, along with her husband. About 1 year ago her family members noticed that her behaviour and action became altered. Such alteration in behaviour was only episodic. A detailed evaluation was done and a diagnosis of Dissociative identity disorder was established. The treatment included psychotherapy facilitated by hypnosis addressing the conflict along with escitalopram 10 mg once a day and clonazepam 0.5mg at night, clonazepam was tapered and stopped within 1 month while escitalopram was hiked upto 20 mg and patient improved along with decrease DES scores.

In Freudian psychology the girl child identifies with her mother and represses her sexual feelings toward her father commonly known as the Elektra complex. In spite of trance and possession syndrome being more prevalent in countries like India, we urge to keep dissociative identity disorder as a differential in order to catch the eye of the clinicians and researchers on the recognition of clinical manifestation and exploration of therapeutic strategies.

No significant relationships.