Suicidality in DID
There is a significant danger of suicidality in persons with dissociative identity disorder (DID). Studies show that 1 to 2.1% of patients with DID have completed suicide, with an incidence of 61 to 72% who have attempted suicide (Brand, 2001). Brand, who is a prominent expert in the field of dissociative disorders, believes this last figure is an underestimate given that therapists who have had patients who committed suicide may be less likely to fill out questionnaires, and that these numbers do not include dissociative patients who have been misdiagnosed or those not in treatment. Brand (2001) stressed that the rates for suicidality are comparable with-or in some cases higher than-suicidality rates for persons with severe depression, for which percentages are approximately 20% attempting and 3.9% completing suicide. Among persons with borderline personality disorder (BPD) the percentages are 75% attempting and 5 to 10% completing suicide; in schizophrenia, the percentages range from 30 to 40% attempting suicide and 10% completing it. In a recent study of psychiatric outpatients, Foote, Smolin, and Lipshitz (2008) found that a dissociative disorder diagnosis was more strongly associated with suicidality or self-harm than any other diagnosis-surprisingly, even more strongly than Major Depression or Borderline Personality Disorder. Furthermore, when dissociative disorder diagnosis and Borderline Personality Disorder diagnosis were entered simultaneously into a regression analysis, with suicidality as the outcome measure, the strong association between dissociative disorder diagnosis and suicidality remained, while the association between Borderline Personality Disorder and suicidality was no longer significant-suggesting that the dissociative disorder accounted for the suicidality of the BPD patients, and not vice-versa.