Multiple personality: an issue for forensic psychiatry

The formulation of Multiple Personality (MP) as a distinctive entity by DSM-III while helpful clinically requires, at best, very rigid evaluatory criteria based on independent verification when used as a defense in a Court of Law. The use of the set of eight criteria developed by specialists are helpful guidelines. A case of MP disorder discovered under hypnosis by a psychiatrist and later on vehemently denied by the patient became the object of legal action as part of a malpractice suit. While some well-known experts consulted during treatment believed that she was a MP, the expert witnesses at the trial felt that the patient was not. As a mixed (borderline-histrionic) personality, the patient possibly might have dissociated under stressful life circumstances. The case raises serious issues about the role of auto-suggestion in mimicking MP. It questions the validity of the use of the diagnosis in Court. Legally only carefully evaluated independent data about incongruent past patterns of behavior suggesting alternate personality, can be considered reliable reference for the diagnosis.