- 期刊
解離性身份障礙之評估和診斷
Assessment and Differential Diagnosis of Dissociative Identity Disorder
摘要
解離性身份障礙（dissociative identity disorder, DID）乃正式認可之精神科診斷，可見諸全球多個國家和地區，研究亦表明DID 在一般人口與精神科病人裡皆非罕見。準確評估和及早診斷，不僅能讓患者受惠、避免不必要之副作用、早日獲得恰當支援，更能節省巨大的社會經濟成本，減低醫療開支。由於華人醫學與心理學文獻裡缺乏關於評估DID 的討論和指南，本文特別回顧相關文獻，概述DID 之評估方法、診斷上之考量，並簡介DID 跟其他常見精神科診斷的異同之處，以讓華人精神健康工作者評估時有所考慮、診斷時有所依據。筆者重申，常規精神健康評估應該包含對解離症狀的評估，而進行精神科診斷時也應該將DID 視為其中一個可能的診斷，不能一開始便排除解離症或DID 的可能性。
並列摘要
Dissociative identity disorder (DID) is an officially recognized psychiatric disorder which can be found in many countries and regions. Studies showed that DID is not rare in the general and psychiatric patient populations. Accurate assessment and early diagnosis benefit the patients, reduce unnecessary side effects and gain early access to appropriate support services. These could also save a huge amount of social and economic costs and reduce medical expenses. As there is a lack of discussion and guidelines on DID assessment in the Chinese medical and psychological literatures, this paper aims at reviewing the relevant literature and summarizing DID assessment methods and concerns when making diagnosis. This paper also highlights the similarities and differences between DID and other common psychiatric disorders as a ground to aid Chinese mental health practitioners when assessing and making diagnosis. The authors emphasize that conventional mental health assessment should include assessment for dissociative symptoms, and DID should be considered as one of the possible diagnoses, and the possibility of dissociative disorders or DID should not be excluded at commencement without careful assessment.