Dissociative Identity Disorder: The Daily PANCE Blueprint
A 28-year-old woman is brought to the psychiatrist by her husband, who reports that she has been "acting like different people" at times. He describes episodes where she seems to have a different voice, uses a different name, and exhibits behaviors and preferences that are unlike her usual self. These episodes have been occurring for the past year and are distressing to both of them. The patient has a history of childhood physical and emotional abuse. She reports experiencing periods of time where she cannot recall personal information or what she has done. She denies any substance use, and there is no history of head trauma. Which of the following is the most likely diagnosis?
A) Dissociative Identity Disorder (DID)
B) Borderline Personality Disorder (BPD)
C) Bipolar Disorder
D) Schizophrenia
E) Malingering
Answer and topic summary
The answer is A) Dissociative Identity Disorder (DID)
Dissociative Identity Disorder (DID), formerly known as multiple personality disorder, is characterized by the presence of two or more distinct personality states and recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events, beyond ordinary forgetfulness. The patient’s history of childhood abuse, the presence of different personalities, and amnesia for certain periods are classic features of DID.
- B) Borderline Personality Disorder (BPD): While BPD can involve identity disturbance and impulsivity, it does not typically include distinct alternate personalities or the extensive amnesia seen in DID.
- C) Bipolar Disorder: Bipolar disorder is characterized by mood swings between mania/hypomania and depression. It does not include alternate personalities or amnesia.
- D) Schizophrenia: Schizophrenia can involve hallucinations and delusions but does not typically manifest as distinct alternate personalities or amnesia.
- E) Malingering: Malingering involves the intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives. There’s no indication in the vignette that the patient’s symptoms are intentional or have external motivations.
View blueprint lesson
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Psychiatry ⇒
