psychiatric disorders
Dissociative Identity Disorder
Prognosis for Dissociative Identity Disorder
Impairment in dissociative identity disorder varies widely. It may be minimal in highly functioning patients; in these patients, relationships (eg, with their children, spouse, or friends) may be impaired more than occupational functioning. With treatment, relational, social, and occupational functioning may improve, but some patients respond very slowly to treatment and may need long-term supportive treatment. Symptoms wax and wane spontaneously, but dissociative identity disorder does not resolve spontaneously. Patients can be divided into groups based on their symptoms: Symptoms are mainly dissociative and posttraumatic. These patients generally function well and recover completely with treatment. Dissociative symptoms are combined with prominent symptoms of other disorders, such as personality disorders, mood disorders, eating disorders, and substance use disorders. These patients improve more slowly, and treatment may be less successful or longer and more crisis-ridden. Patients not only have severe symptoms due to coexisting mental disorders but may also remain deeply emotionally attached to their abusers. These patients can be challenging to treat, often requiring longer treatments that typically aim to help control symptoms more than to achieve integration. 