Am J Psychiatry 1991; 148:458-462
Copyright © 1991 by American Psychiatric Association
Diagnosing dissociative disorders in The Netherlands: a pilot study with the Structured Clinical Interview for DSM-III-R Dissociative Disorders
S Boon and N Draijer
Regional Institute for Mental Health (RIAGG Zuid/Nieuw-West), Amsterdam, The Netherlands.
OBJECTIVE: 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. METHOD: 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. RESULTS: 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). CONCLUSIONS:
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.
