Dissociative identity precipitated by emergence from general anesthesia: A case report and analytical framework
Gregory W. Kirschen, Mary E. Shorey, Joan C. Han, Idris Leppla, Courtney Masear, Jennifer Robinson
Psychiatry Research Case Reports July 26, 2023 DOI: 10.1016/j.psycr.2023.100152 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A woman with a history of childhood sexual abuse and past suicide attempt |
| Duration | Episode resolved within 90 minutes; patient discharged on hospital day two |
| Keywords | Dissociative identity disorder Dissociative disorders Psychosocial Multiple personality disorder Sexual abuse Personality psychology Dissociation chemistry Psychopathology Psychotherapist Clinical psychology Psychoanalysis Poison control Suicide prevention Medical emergency |
| Key findings | Anesthesia emergence can precipitate a dissociative identity episode in a person with a history of childhood abuse and suicide attempt. |
Abstract
Background: Dissociative identity disorder (DID) is a complex and controversial psychiatric condition in which one person maintains at least two separate and distinct personalities. Patients with DID often report a history of childhood abuse and may have other comorbid psychiatric conditions. Psychosocial stressors may be triggers for DID inception or recurrence. While anesthetic agents, in particular ketamine, may induce a temporary dissociative state, it has not yet been reported that anesthesia can precipitate a dissociative identity. Case report: We report a case of a woman with a history of childhood sexual abuse and past suicide attempt who experienced an episode of dissociative identity on emergence from anesthesia. The episode resolved within 90 minutes and the patient was discharged home safely on hospital day two.
Conclusion: This case adds to the literature of potentially precipitating factors of DID and we provide a unifying mechanistic hypothesis linking anesthesia to functional brain connectivity.