1.  General guidelines about Dissociative Disorder

·       A disorder characterized by the presence of two or more identities with distinct patterns of perception and personality which recurrently take control of the person's behavior; this is accompanied by a retrospective gap in memory of important personal information that far exceeds ordinary forgetfulness. The changes in identity are not due to substance use or to a general medical condition.

·      A dissociative disorder in which the individual adopts two or more distinct personalities. Each personality is a fully integrated and complex unit with memories, behavior patterns and social friendships. Transition from one personality to another is sudden.

· At least two distinct and relatively enduring personality states, recurrent episodes of dissociative amnesia, inexplicable intrusions into consciousness self, depersonalization and derealization, intermittent functional symptoms, emotion and behavior dysregulation

·       Feeling of disconnected from yourself and the world around

(e.g.,  voices, in    sense   of neurological

·       Forgetting about certain time periods, events and personal information

·       Feeling uncertain about who you are

·       Having multiple distinct identities

·       Feeling little or no physical pain

History taking and examination including MSE                                                                                                            Annexure 1 Special emphasis

·       Medical history

2.  a) Investigations required

a.     Psychometric investigations: to confirm the diagnosis and to rule out Differential Diagnosis

b.  Laboratory: (if physical complications are present)

b)    Comorbidity: Post Traumatic Stress Disorder and Depressive disorder, Somatization disorder and borderline personality disorder.

c)  Differential Diagnosis: Personality Disorder and Psychotic Disorder.

3.  Treatment

a)  Psychopharmacology

·       SSRI's

·       Symptomatic and supportive

b)  Psychosocial Intervention

a.  If patient is in early stage

i)     Psychoeducation– Nature of illness, etiology, progression, consequences, prognosis, treatment.

ii)  Talk therapy

b.  If patient is in mid or late stage

i)  Cognitive Behaviour Therapy

ii)  Support group

4.  Follow-up

a.  Psychiatry OPD/ DMHP

·       Initially once in two weeks for 2 months

·       Monthly check up for 1 year.

b.  Physical check-up at OPD

c.  Through telephonic conversation/TeleManas 14416/18008914416

d.  Follow-up by Targeted Intervention (ARDSI-Mizoram Chapter) in Aizawl.

5.  Referrals

a.   Depending upon the severity and complications of the patient, he/she may need to be referred to Psychiatry/medicine department.

b.  To TeleManas

c.  To the nearest DMHP

d.  To psychiatry OPD at Kulikawn Hospital and ZMC

e.  To higher centers outside Mizoram through Referral Board.