Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002622 (amnesia)
 5,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Unprecedented numbers of cases of MPD have been diagnosed, mainly in North America, since 1957. Widespread publicity for the concept makes it uncertain whether any case can now arise without being promoted by suggestion or prior preparation. In order to determine if there is any evidence that MPD was ever a spontaneous phenomenon, a series of cases of MPD from the earlier literature has been examined, with particular attention given to alternative diagnoses which could account for the phenomena reported and to the way in which the first alternate personality emerged. The earlier cases involved amnesia, striking fluctuations in mood, and sometimes cerebral organic disorder. The secondary personalities frequently appeared with hypnosis. Several amnesic patients were trained with new identities. Others showed overt iatrogenesis. No report fully excluded the possibility of artificial production. This indicates that the concept has been elaborated from the study of consciousness and its relation to the idea of the self. The diagnosis of MPD represents a misdirection of effort which hinders the resolution of serious psychological problems in the lives of patients.
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PMID:The manufacture of personalities. The production of multiple personality disorder. 843 7

Chronic complex dissociative symptoms can be readily inquired about in the diagnostic interview leading to a clinical diagnosis of MPD in many cases. It is most useful to begin with inquiry about amnesia, autohypnotic, posttraumatic, pseudopsychotic, and passive-influence symptoms, and childhood abuse or traumatization. As this proceeds, overt dissociation is commonly noted including spontaneous trances, age-regression, blending or overlap of states, or frank switching. When this occurs, the interviewer can pursue more detailed information about the patient's experiences. Tracking these processes may readily lead to the clear appearance of an alter personality or will help make the patient sufficiently comfortable that he or she will allow the full emergence of an alter if this is directly requested. In other cases, however, methods such as use of ideomotor signals, formal induction of trance, and even barbiturate-facilitated interviews may be necessary to permit the full emergence of an alter. The symptom-cluster method is a useful clinical diagnostic tool to elicit dissociative symptoms for the diagnosis of MPD. Combined with diagnostic tools such as the DES, the DDIS, and the SCID-D, this method can help the clinician make the diagnosis of MPD in a far more expeditious and rigorous fashion. In addition, all psychiatric patients should be screened for a history of blackouts, time loss, trance experiences, childhood trauma, and PTSD symptoms. This will improve case finding to help clinicians begin to treat the single largest preventable cause of mental illness: the sequelae of childhood abuse, trauma, and family violence.
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PMID:An office mental status examination for complex chronic dissociative symptoms and multiple personality disorder. 194 25

As clinicians become more sophisticated regarding MPD, we can expect many more cases to come to the court's attention, especially among violent offenders. This is because violence and MPD have very similar origins in early extraordinary physical and sexual abuse. As offenders become more knowledgeable, we can also expect to encounter more and better malingering. At this time, however, we are far more likely to overlook the problem than we are to overdiagnose it. Why is it that MPD is recognized so infrequently in the offender population? Probably because so many of its characteristics are similar to the symptoms associated with antisocial personality. For example, amnesia for behaviors is dismissed as lying, fugue states appear to be attempts to evade justice; finding things in one's possession looks like stealing; self-mutilation and suicide attempts seem manipulative; and the use of different names at different times and in different circumstances is interpreted as the conscious use of aliases in order to evade the law. Even the dramatic, at times heart-wrenching emotional catharses relating to abuse revealed during hypnosis are so painful that the average person has difficulty accepting that they happened and, therefore, dismisses them as exaggeration or total fabrication. Most often, the diagnosis is missed because the clinician does not even consider it a possibility. In this article we have reviewed some of the ways in which courts have approached the issue of MPD and some of the problems specific to its diagnosis in forensic settings. The clinician must keep in mind that in cases in which issues of mental illness are raised, the law reflects that which it is taught by alleged experts. The case law on multiple personality is still sparse, leaving much room for new data and new interpretations of these data. The current tendency to treat each alternate as though it were a whole and responsible individual as opposed to an imaginary construct, a symptom of a mental illness, reflects the confusion among clinicians as well as attorneys regarding the phenomenon of MPD. As we continue to learn more about the disorder and its forensic implications, we must be careful to avoid presenting to the court clinical impression as fact or mythology as truth.
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PMID:Multiple personality and forensic issues. 194 33

Dissociative disorder is well-known in adulthood but in many cases it begins in childhood where it is usually not taken into consideration, rarely diagnosed, and often mistaken with borderline disorders. In childhood dissociation is well-defined: in a dimensional way by the presence of the dissociation symptoms over 2 SD and in a categorial view by the presence of primary symptoms. We made a psychiatric assessment on a child aged 11 years and 7 months, who said he heard "voices in his head". The assessment included: Children Dissociative Checklist (CDC), Adolescent Dissociative Experience Scale (A-DES), Children Depression Inventory (CDI), Wechsler Intelligence Scales for Children-Revised (WISC-R), Strength and Difficulties Questionnaire (SDQ), Children Behaviour Check-list (CBCL), (Scale Disturbi Attenzione Genitori, parent attention deficit scale, SDAG), Parent Conners Questionnaire, free conversation, a drawing, a neurological examination, an EEG-Holter and a semistructured psychiatric interview: K-SADS PL 1.0. SDQ, CDI and CBCL showed pathological scores in every area. K-SADS PL 1.0 excluded schizophrenia and showed: attention deficit, disthymic disorder, generalized anxiety disorder, oppositive-defiant disorder and conduct disorder with rage episodes, like borderline disorder. I.Q. was 76, SDAG (total 46) and Conners (mean points 1.81) showed a high score, simulating Attention Deficit with Hyperactivity disorder (ADHD). The presence of primary symptoms, like dissociative amnesia and very high scores in CDC (23, mean score for MPD) and in A-DES (85, mean 4.2) are useful for diagnoses. Dissociative disorder also exists in childhood, but it should be differentiated from ADHD and borderline disorder.
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PMID:Dissociative disorder in children. A case study. 1545 42