Diagnosing dissociative disorders in The Netherlands: a pilot study with the Structured Clinical Interview for DSM-III-R Dissociative Disorders

Abstract

To improve the ability to diagnose dissociative disorders in The Netherlands, the authors conducted a study using a Dutch version of the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D) with additional questions on childhood trauma and symptoms of borderline and histrionic personality disorders. All interviews were audiotaped or videotaped and rated by two investigators separately. Forty-four patients (42 women and two men) participated in the study. Most of the patients had been referred for evaluation of dissociative symptoms; five had participated in a nationwide survey on incest. None of the patients had ever received a diagnosis of a dissociative disorder, and none had evidence of organic brain syndrome or mental retardation. All patients were in active treatment; 23 were being treated in an outpatient psychiatric service, 13 in an inpatient psychiatric service, and eight in private practice. Thirty-two patients had been psychiatric inpatients at least once. Four diagnostic groups of patients were identified: two with dissociative disorders (12 patients with multiple personality disorder and 11 with dissociative disorder not otherwise specified), one with DSM-III-R personality disorders (11 patients), and one without dissociative or personality disorders (10 patients). Dissociative disorders are clearly not only an American phenomenon. The diagnosis can be made outside of the United States if the symptoms are sought. The SCID-D proved to be a promising instrument.