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Tijdschrift voor Psychiatrie 40 (1998) 10, 602 - 614

New research

Dissociative Identity Disorder in the Netherlands: A survey of diagnosis and treatment by psychiatrists

H.N. Sno, H.F.A. Schalken

Dissociative Identity Disorder is a controversial diagnosis. Few data are available on the efficacy of treatment modalities. A questionnaire has been mailed to 1,452 Dutch psychiatrists to survey the frequency of the diagnosis, their treatment practices and some demographic data on the patients.
The response rate is 46.7%. The cohort of respondents would seem to have constituted a representative sample. A total of 273 (41.8%) psychiatrists reports having made the diagnosis at least once. No correlation is observed with theoretical frame of reference or the type or topography of work facility. There is however a significant correlation with the psychiatrists' gender, age and years of experience. The mean age of the illustrative patients is 33.19 and the m/f ratio 1 : 9. The majority of the patients is seen once a week in an outpatient setting.
Conclusion: Individual psychotherapy and adjunctive anxiolytic or antidepressant medications are the most widely endorsed treatment modalities. Hypnosis is rarely used. The diagnosis Dissociative Identity Disorder could not be dismissed as a nonsensical notion on the part of a small and local sect of believers. It is warranted as an explanatory model and conceptual framework for the psychotherapeutic treatment of complex psychological phenomena and psychiatric symptoms.