OBJECTIVE: Dissociative identity disorder (DID) is a disorder characterized by repeated emergence of one or more personalities for a person, which dominates the person’s life for a short or long term; where these personalities and identities don’t know each other, and are not informed about their behaviors and where the person forgets the previous actions completely. DID patients generally don’t consult to the doctor with identity or memory problems which constitute the main characters of the disorder. However, indirect or secondary symptoms that develop within time, manifestations, syndromes, complications, occasional complaints resulting from additional diagnoses or acute crisis leading to emergencies may lead consultation to doctor. These difficulties in diagnosis increase the importance of recalling this disorder in patients who apply to clinics with different complaints. On this poster we present a patient with acromegaly diagnosis who had applied with dissociative symptoms, we had diagnosed as DID.
CASE: 37-year old, married with one child, primary school graduate female patient. It was determined that the patient with the diagnosis of acromegaly had been using hydrocortisone 10 mg/day and levotiron 10 mg/day for 16 years and that the first psychiatric referral was when she was brought to the emergency room by her relatives after a senkop for a few minutes, which she didn't remember, during the funeral of her uncle. During policlinic follow-up, she was found to have behaviors that occur 2-3 times a week for 3-4 minutes, which she didn't remember and where she attempted to throw herself out of the window, tried to burn her clothes with cigarette and stove, and she tried to stab her relatives. The patient was diagnosed with DID.
DISCUSSION: Patients with psychotic disorder, depression and anxiety disorders accompanying acromegaly have been reported in the literature. Although acromegaly cannot be clearly associated with psychiatric findings in these patients, acromegaly should be considered as an important factor because of the risks of exacerbation of the findings in the follow-up hormone treatments and the difficulties of social life caused by acromegaly affect the prognosis of the disease. In our case, dissociative findings and acromegaly diagnosis and treatment did not start at the same time, but the traumatic experiences created by the acromegaly symptoms in the story were important.