Transtorno dissociativo de identidade e esquizofrenia: aspectos históricos e desafios diagnósticos - uma revisão da literatura

Abstract

The concept of dissociation in the field of psychopathology dates back to the phenomenon of division of psychic functions. Different explanatory models discuss the genesis of this process, including theories that attribute it to exposure to trauma and sociocultural factors, and a transtheoretical model is also proposed. Dissociative identity disorder is characterized by a serious condition in which the individual is affected by recurrent identity changes and episodes of dissociative amnesia. There is an overlap in clinical manifestations between dissociative identity disorder and schizophrenia, causing changes in the diagnosis and treatment instituted in individuals. This is a narrative literature review, in which bibliographic research was carried out on the diagnostic challenges between dissociative identity disorder and schizophrenia, covering historical factors. It is observed that the challenge in this differentiation has been present since Bleuler discussed the phenomenon of division of the self, considered fundamental to schizophrenia, but which referred to the initial concept of dissociation. There are descriptions of first-rank symptoms present in both disorders. This correlation can be understood from a dimensional perspective, with both pathologies being present on a continuum, in which schizophrenia would be at the extreme, representing a particular type of pathology of the self. The concept of a continuum in mental illness goes back to the idea that all forms of psychopathology may be interconnected, fostering debate on the importance of new research from a transdiagnostic perspective.