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Dissociative identity disorder(DID) is characterized by the existence of two or more distinct identities which involve changes in consciousness, emotion, memory, and behavior. It is associated with childhood traumatic experiences and other psychiatric disorders. Comorbidity in DID can lead to complex clinical presentations, poor treatment responses. Thus, it is crucial to identify patients with comorbidity and take them into the treatment plan.
Objectives
We aim to report a case of DID and Attention-Deficit/Hyperactivity Disorder(ADHD) comorbidity.
Methods
A case report is presented alongside a review of the relevant literature regarding “dissociative identity disorder” and “attention deficit hyperactivity disorder”.
Results
We describe the case of a 39-year-old woman with DID, onsetting at age 25, who had consistently responded poorly to long-term psychotherapy and pharmacological treatment. She presented with anxiety, distinct personality states, alterations in memory, consciousness and behavior problems in functioning, and high Dissociative Experiences Scale(DES) scores. Throughout the interviews, we noticed that she had limited attention, excess movements. After a detailed evaluation, diagnosis of ADHD is established, using the Diagnostic Interview for ADHD(DIVA) and ADHD Self-Reporting Scale(ASRS). Methylphenidate was prescribed in addition to previous medication. İmprovement in the severity of both ADHD and DID symptoms was presented with lower scores in DES and ASRS after the introduction of methylphenidate with progressive dose adjusting till 60mg/day.
Conclusions
Although previous studies demonstrated ADHD symptoms are related to dissociation, there is no well-established strategy for this. We believe that this case report provides a better approach to the comorbidity of ADHD and DID.
Separation anxiety disorder (SAD) is probably the most common anxiety disorder presenting during childhood and may increase the risk of subsequent anxiety and mood disorders. Recent reviews conclude that childhood sexual abuse (CSA) is a significant, albeit nonspecific, risk factor for the development of eating disorders (EDs), particularly those with bulimic features that present in association with psychiatric comorbidity. Since traumatic experiences and subsequent post-traumatic stress disorder (PTSD) are associated with an array of psychiatric disorders similar to those found in association with bulimic EDs, and bulimic EDs are linked with trauma and PTSD, then it is reasonable that trauma and PTSD may mediate the association between psychiatric comorbidity and bulimic EDs. This chapter examines our present knowledge regarding the most common comorbid psychiatric conditions seen in association with eating disorders in children and adolescents.
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