dissociative disorder, any of several mental disturbances in humans in which

normally integrated mental functions, such as identity, memory, consciousness,

or perception, are interrupted. Dissociative disorders can occur suddenly or gradually
and may last for a short time or become chronic. There are different forms of
dissociative disorders; they include dissociative identity disorder, dissociative amnesia,
dissociative fugue, depersonalization disorder, and dissociative disorder not otherwise
specified.
Dissociative identity disorder
Dissociative identity disorder (formerly called multiple personality disorder) occurs
when an individual displays two or more different personality states or identities that
recurrently take control of the person’s behaviour. The patient may be unable to recall
events over the span of time when another personality has assumed control. Dissociative
identity disorder is a chronic and complex disorder and may result from severe
childhood abuse (physical, emotional, or sexual) or neglect. It is diagnosed more
frequently in women than in men.
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Most individuals who are affected by dissociative identity disorder are unaware of their
condition and may seek treatment for depression. Many patients receive
other diagnoses prior to treatment and may not respond to medications. The transition
(“switch”) from one personality to another is usually sudden. The degree of impairment
depends on the manner in which various personality states interact with each other. The
switching is a vulnerable time. Patients may attempt suicide, mutilate themselves, or
become violent toward others. Some patients may undergo long-term psychodynamic
psychotherapy, which attempts to expose unconscious sources of suffering.
Dissociative amnesia
Dissociative amnesia is characterized by an inability to recall important personal
information that often is associated with stress or trauma. It may be localized (inability
to recall events during a circumscribed time), selective (can recall only some aspects of
an event), continuous (ongoing amnesia following a specific event), or systematized
(inability to recall certain categories of events). Dissociative amnesia can occur at any
age but is rare in children. Its incidence is increased in soldiers in combat. It is
reversible, usually beginning and ending suddenly. Recurrences are not uncommon. In
severe or acute cases, hypnosis and amobarbital interview (administration of
the sedative-hypnotic drug amobarbital to obtain information that the subject otherwise
cannot recall) may be helpful in retrieving lost memory.
Dissociative fugue
Dissociative fugue (psychogenic fugue, or fugue state) presents as sudden, unexpected
travel away from one’s home with an inability to recall some or all of one’s past. Onset is
sudden, usually following severe psychosocial stressors. This state usually lasts for
minutes to days but may be prolonged for months. Although confusion may be present,
most individuals appear to be mentally intact and do not draw attention to themselves.
Depersonalization disorder
Depersonalization disorder presents as recurrent episodes of depersonalization in which
one feels detached or alienated from oneself. The person may feel like an observer
watching himself or herself as if in a dream or movie. Depersonalization disorder
usually occurs in adolescence or adulthood. Most patients experience anxiety, panic, or
depression. The clinical course may be chronic with recurrences following stressful
events. Impairment is usually minimal, and most patients function well, although some
become incapacitated from fear of going insane.