Iatrogenic Factors in the Misdiagnosis of Multiple Personality Disorder

The diagnosis of multiple personality disorder (MPD) is fraught with difficulties leading to a frequent false negative diagnosis and an occassional false positive diagnosis. Proper diagnostic evaluation of a patient suspected of having MPD requires a familiarity with MPD, hypnoticphenomena, and a wide variety ofother clinical syndromes. The clinician must use collateral data from old records and other individuals as well as provide sufficient time for the evaluation. Extreme caution is urged in forensic contexts. The use ofextremely suggestive interviewingand/or hypnotic techniques is to be deplored. At times prolonged observation in the hospital or over the course oftherapy is required. Clinicians should be patient, skilled in listening, and should keep an "open mind. " Patientfactors involved in producing misdiagnosis include distrust, fear of being labeled crazy, insistence on secrecy, amnesia, and conscious or unconscious