This document discusses the treatment of multiple personality disorder (now called dissociative identity disorder). It states that the disorder is complex and influenced by individual, family, and social factors. No single treatment approach is adequate as it is a multifaceted disorder. Treatment involves pharmacological, psychological, and social strategies including diagnosis, medication stabilization, addressing safety issues, and reducing stress through structuring daily activities. Hospitalization of 4-6 weeks can be as effective as longer term stays. Main treatments include medications and therapies to address symptoms rather than cure the disorder.

1. Dr. S. Krishnan
Associate Professor of Psychiatry
Government Medical College
Thiruvananthapuram

3. Is not multiple personality disorder
A complex disorder which occurs in a person with unique
individual, familial and social psychological profile
Unknown, probably specific, environmental and
psychological factors might contribute to the development
of the disorder
No one therapeutic approach is adequate to deal with this
multifaceted disorder

4. How the patient has
been affected?
How the patient can be
helped by the treatment?

5. Pharmacological
Psychological
Social strategies

6. Diagnosis
Stabilization of medications
Patient’s safety – suicidal or homicidal ideation
Grossly disorganized or inappropriate behavior –
inability to take care of food, clothing and shelter

7. Reduces patient’s stress
Helps the patient to structure the daily activities
Short stays of 4-6 weeks is as effective as long term
hospitalization
Hospital settings with active behavioral approaches
produce better results than do custodial institutions

8. Mainstay of treatment
Treat the symptoms
Not cure
About 2-4 times as many patients relapse when treated with
a placebo as do those treated with antipsychotic drugs

9. Typical
antipsychotic
drugs
Atypical
antipsychotic
drugs

10. What are the major distressing symptoms?
Has the patient ever responded any
particular medicine in the past?
Has the patient taken treatment with drugs
for adequate period of time (4-6 weeks)

11. Poor response to two different drugs when given in
adequate dose for adequate period of time?
Unpleasant reaction to first dose or unpleasant
reaction during the initial week – subjective negative
feeling, over-sedation, any severe side effects?
Severe depression or irritability or excitement?

12.  Helps to increase
 Social abilities
 Self sufficiency
 Practical skills
 Interpersonal
communication
Social skills Training
Family Therapy
Group Therapy
Cognitive Behavior therapy
Individual Psychotherapy
Vocational Therapy

13.  Has shown to reduce relapse rates as measured
by need for hospitalization
 Relationship problems
 Poor eye contact
 Unusual delays in response
 Odd facial expressions
 Lack of spontaneity in social situations
 Inaccurate perceptions
 Lack of perceptions of emotions in other individuals

14.  When family plays a role in precipitation of
symptoms, perpetuation of symptoms or
maintenance of symptoms

15. Focus is on:
Effective in reducing
social isolation, increasing
sense of cohesiveness and
improving reality testing
Real life plans Real life problems Relationships

16. Helps to
reduce:
Cognitive
distortions
Reduces
distractibility
Correct errors
of judgment
Ameliorates
delusions and
hallucinations

17. Effect additive to
pharmacotherapy
Helps develop good personal
relationship with therapist – a
predictor of outcome.

18. Sheltered workshops
Job clubs
Part time employment
Transitional employment programs

19. Visit an individual with Schizophrenia whom you
know
Spend some time with him/her
If you don’t know anybody, take a decision that you
will care for any individual with schizophrenia, if
ever you come across

20. Medicine is not the treatment of choice for
schizophrenia
Ask your doctor for what
nonpharmacological methods are good
and effective for your relative with
schizophrenia.