ABSTRACT

Dissociative Identity Disorder (DID), an illness characterized by multiple personality states, has long been a controversial diagnosis within the psychiatric community. Demonstrating a neuroanatomical basis for the disorder may help to resolve the controversy. Current literature on the neuroanatomy associated with DID has focused on the hippocampus and amygdala and are inconclusive. This meta-analysis pools the results from n = 3 studies to compare the mean size of these two structures between DID patients, non-DID patients, and healthy controls. Patients diagnosed with both DID & PTSD were found to have smaller hippocampi bilaterally (p< .001) compared to healthy controls; no significant difference was seen in the amygdala. When comparing DID to PTSD patients, the left hippocampus was smaller (p< .001), with a trend for a smaller right hippocampus (p = .06). A comparison of the amygdala was not possible due to a lack of data. These findings suggest that a smaller hippocampus is seen in DID patients beyond what is seen for PTSD, provides neuroanatomical evidence for the memory impairment often seen in DID patients (i.e., amnesia experienced by the host and alters), and presents a potentially novel means to understand this disorder.

摘要

分离性身份障碍（DID）是一种以多种人格状态为特征的疾病，长期以来一直是精神病学界颇有争议的诊断。证明该疾病的神经解剖学基础可能有助于解决争议。与DID相关的神经解剖学的最新文献集中在海马和杏仁核上，尚无定论。该荟萃分析汇总了n = 3个研究的结果，以比较DID患者，非DID患者和健康对照者这两种结构的平均大小。与健康对照组相比，被诊断为DID和PTSD的患者双侧海马体较小（p <.001）。杏仁核未见明显差异。将DID与PTSD患者进行比较时，左海马体较小（p <  .001），且右海马区较小（p = .06）。由于缺乏数据，无法比较杏仁核。这些发现表明，在DID患者中发现的海马体较小，超过了PTSD所见，为DID患者中经常出现的记忆障碍（即宿主经历的遗忘症和改变）提供了神经解剖学证据，并提出了一种潜在的新方法了解这种疾病。