游离性身份沉淀的出现从全身麻醉:一个病例报告和分析框架

Psychiatry research case reports Pub Date : 2023-07-26 DOI:10.1016/j.psycr.2023.100152

Gregory W. Kirschen , Mary E. Shorey , Joan Han , Idris Leppla , Courtney G. Masear , Jennifer Robinson

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引用次数: 0

摘要

背景分离性身份障碍（DID）是一种复杂而有争议的精神疾病，一个人至少保持两种不同的个性。DID患者经常报告有儿童虐待史，并可能有其他共病精神疾病。心理社会压力源可能是DID开始或复发的诱因。虽然麻醉剂，特别是氯胺酮，可能会诱导暂时的解离状态，但尚未有报道称麻醉会导致解离身份。病例报告我们报告了一名有童年性虐待史和自杀未遂史的妇女的病例，她在麻醉后出现了一段分离的身份。该事件在90分钟内解决，患者在住院第二天安全出院回家。结论该病例增加了DID潜在诱因的文献，我们提供了一个统一的机制假说，将麻醉与大脑功能连接联系起来。

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Dissociative identity precipitated by emergence from general anesthesia: A case report and analytical framework

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 min 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.

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Psychiatry research case reports Medicine and Dentistry (General)

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