Chapter 1. Dissociative Disorder in the Modern Era (8)

＜Those who were misdiagnosed with schizophrenia＞

In current psychiatry, there is a high chance that a patient with DID is misdiagnosed with schizophrenia or any other psychotic states. In their initial psychiatric visit, most probably they leave the office with a prescription of antipsychotic medications, or an emergency psychiatric hospitalization ordered for them. The real victims are patients and their family members while psychiatrists are almost never blamed for their poor diagnostic skill. There are too many patients who seek psychiatric help and they don’t have many choices but to see whoever psychiatrist is available. However, some psychiatrists really lament this state and are active in changing the situation. A bestseller “Second Opinions in Psychiatry”(Seishinka Second Opinion”) is written by one of these psychiatrists (Ryu, Y. MD) in collaboration with the family members of those who are the victims of psychiatrists’ misdiagnosis (Ryu, et al. 2008). This book gives many examples of psychiatrist’s diagnostic errors, and dissociative disorders are one of the most frequent disorders to be mistaken for something else.
For these misdiagnoses, psychiatrists are not only to blame, but the education system that they go through can be very insufficient. Many psychiatrists in their initial training are not really taught that patients can hear voices other than in psychotic conditions. If they are stuck with the outdated diagnostic system, when they face people with DID, diagnosis other than schizophrenia or other types of psychosis never come up to his mind.
When a patient admits to hearing voices and is found to be in an agitated condition, the attending psychiatrist usually go by a principle of “when in doubt, treat as schizophrenic” and “acute neuroleptization” can be initiated: patients can be placed in five-point restraints and is given IV line and a diaper. Many DID patients remember this process scary and traumatic.