Dissociativní porucha identity u dětí a adolescentů

The authors describe the basic characteristics of dissociative personality identity disorders and focus their attention in particular on its manifestations in children and adolescents. This disorder is described in the International Classification of Diseases-10 as a multiple personality disorder. It is assumed that a traumatic experience in childhood (in particular maltreatment and sexual abuse) can lead to dissociative disorders of mental development. It involves repeated traumatic experience where the child can assume that they will occur again and which he cannot avoid. The child's traumatic experience is inconsistent with his usual experience. Dissociation is a defence mechanism which helps the child to endure the trauma. It is more difficult to diagnose the disorder in children than in adults. Different "personalities" are in children less structured and fixed. Manifestations of the disorder may be underrated assuming that a mere play or phantasy are involved. The diagnosis of the disorder in children is suggested by multiple symptoms, deviations of mood and behaviour, manifestations of aggressivity towards himself and others, manifestations of amnesia and the history of different diagnoses. From the therapeutic aspect individual dynamic therapy is indicated, hypnotic techniques may be also useful. In younger children also game techniques are used.