Selected Aspects of Diagnosis and Therapy in Dissociative Identity Disorder (DID)-Case Report

Introduction: Dissociative identity disorder (DID) is a condition characterized by the presence of at least two distinct identities. The experience of severe trauma, particularly in childhood and especially related to physical and emotional abuse, is considered the most common etiological source, leading to the development of dissociative mechanisms, as confirmed by both the literature and the authors' research findings. The diagnosis of DID is complex and requires a multimodal approach. This report presents a comprehensive psychiatric and psychological assessment using an integrated diagnostic framework combining clinical observation, psychometric evaluation, and neuroimaging. Methods: A 33-year-old woman presented to the Psychiatric Clinic due to numerous amnestic episodes and recurrent identity switches, resulting in a lack of continuity in autobiographical memory and heterogeneous functioning. The patient had previously been treated at the Mental Health Outpatient Clinic with suspected schizophrenia. The patient's history was difficult to collect and switches between identities were observed, with a marked change in behavior. The patient declared the presence of 46 different personalities. The stories she reported changed, depending on the dominant identity, each of which varied in terms of gender, name, sexual orientation, interests, or pattern of behavior. Results: The patient underwent a thorough laboratory diagnosis, including toxicologic diagnosis, neuroimaging, and psychological diagnosis. On the basis of the information collected, based on the ICD-10 Classification, the diagnosis was: F44.8-dissociative identity disorder. Discussion: The clinical entity described by the authors still poses many diagnostic and therapeutic uncertainties. In the literature, we do not find a case description that holistically encompasses DID. Therefore, the following description represents a unique bibliographic item that is useful to professionals in planning medical and therapeutic care.