Prevalence

“As an undergraduate student in psychology, I was taught that multiple personalities were a very rare and bizarre disorder. That is all that I was taught on ... It soon became apparent that what I had been taught was simply not true. Not only was I meeting people with multiplicity; these individuals entering my life were normal human beings with much to offer. They were simply people who had endured more than their share of pain in this life and were struggling to make sense of it.”

― Deborah Bray Haddock, The Dissociative Identity Disorder Sourcebook

Prevalence


Most current studies place the prevalence of dissociative identity disorder (DID) between 0.1% to 2%, though a few give estimations as high as 3-5%. The DSM-5-TR gives the 12-month prevalence of DID in a small community of American adults as 1.5%, and lifetime prevalence in a representative sample of Turkish women as 1.1% (American Psychiatric Association, 2022). As reviewed by Kate et al. (2019), other general population estimates obtained with dissociation-specific screening or diagnostic tools have ranged from 0.8% to 1.5%, with an additional 0.2% to 8.3% for other specified dissociative disorder (OSDD), which may or may not present as similar to DID. Dissociative disorders as a whole ranged from 3.0% to 18.3%.


DID and dissociative disorders as a whole are more common in clinical settings. DID has been determined to affect between 6% to 10% of inpatients (Horen, Leichner, Lawson, 1995; Ross, Duffy, & Ellason, 2002). In an American outpatient setting, it was found to affect 6% of the population (Foote et al., 2006). Interestingly, high rates have also been found in many studies of college students. In a meta-analysis of 31,905 college students, 11.4% had any dissociative disorder, with a range of 5.5% to 28.6% across samples. 3.7% had DID, and 4.5% had DDNOS/OSDD. Additionally, 9.8% to 16.6% of students screened positive for elevated pathological dissociation in studies where further assessment was not undertaken. Higher dissociation as measured by the DES was found in countries with lower safety rankings (Kate et al., 2019). 


While some studies find that DID is up to 9 times more common in females than males, other studies place the rates of prevalence equal for both groups. It is thought that the discrepancy in diagnosis between males and females might be due to many males with DID not entering therapy or being incarcerated (a common explanation for diagnoses more commonly attributed to females). It's also thought that males may be more likely to deny their symptoms and trauma history. A discrepancy in diagnoses between genders is not visible in child, adolescent, or general population settings (American Psychiatric Association, 2022).


It is frequently claimed that DID is a uniquely rare disorder. However, when comparing DSM prevalence rates, this is simply not true. If a prevalence rate of 1.5% is accepted for DID, it is comparable to DSM-IV chronic major depressive disorder (1.5%), DSM-5 bulimia nervosa in women (0.46%-1.5%), and obsessive compulsive disorder (1.1%-1.8%); it is more common than intellectual disability (1%), autism spectrum disorder (1%-2% in the United States but 0.62% globally), schizophrenia (0.3%-0.7%), and persistent depressive disorder (dysthymia)(0.5%); and it is only slightly less common than panic disorder (1.7%-3%), adult ADHD (2.5%), and DSM-IV bipolar I, bipolar II, and bipolar disorder not otherwise specified combined (1.8%-2.7%) (American Psychiatric Association, 2022). That DID is more prevalent than or equally prevalent as autism spectrum disorder is perhaps most striking as it's often said that there's an autism "epidemic."


The prevalence rate of DID does vary between countries, but epidemiological general population studies still place the prevalence of DID at 1.1-1.5% and the prevalence of any DSM-IV dissociative disorder at 8.6-18.3% (Martinez-Taboas, Dorahy, Sar, Middleton, & Krügar, 2013). 




American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., Text Revision).

Foote, B., Smolin, Y., Kaplan, M., Legatt, M., & Lipschitz, D. (2006). Prevalence of dissociative disorders in psychiatric outpatients. American Journal of Psychiatry,163(4), 623-629. doi: 10.1176/appi.ajp.163.4.623

Horen, S., Leichner, P., & Lawson, J. (1995). Prevalence of dissociative symptoms and disorders in an adult psychiatric inpatient population in Canada [Abstract].The Canadian Journal of Psychiatry / La Revue Canadienne De Psychiatrie, 40(4), 185-191.

Kate, M., Hopwood, T., & Jamieson, G. (2019). The prevalence of Dissociative Disorders and dissociative experiences in college populations: A meta-analysis of 98 studies. Journal of Trauma and Dissociation, 21(1). doi: 10.1080/15299732.2019.1647915

Martinez-Taboas, A., Dorahy, M., Sar, V., Middleton, W., & Krügar, C. (2013). Growing not dwindling: International research on the worldwide phenomena of dissociative disorders [Letter to the editor]. Journal of Nervous & Mental Disease, 201(4), 353.

Ross, C., Duffy, C., & Ellason, J. (2002). Prevalence, reliability and validity of dissociative disorders in an inpatient setting. Journal of Trauma & Dissociation, 3(1). doi: 10.1300/J229v03n01_02

“The lifetime prevalence of dissociative disorders among women in a general urban Turkish community was 18.3%, with 1.1% having DID (ar, Akyüz, & Doan, 2007). In a study of an Ethiopian rural community, the prevalence of dissociative disorders was 6.3%, and these disorders were as prevalent as mood disorders (6.2%), somatoform disorders (5.9%), and anxiety disorders (5.7%) (Awas, Kebede, & Alem, 1999). A similar prevalence of ICD-10 dissociative disorders (7.3%) was reported for a sample of psychiatric patients from Saudi Arabia (AbuMadini & Rahim, 2002).”


― Paul H Blaney, Oxford Textbook of Psychopathology