KIDNEY-TRANSPLANTATION AND LIAISON PSYCHIATRY .2. A CASE OF DISSOCIATIVE IDENTITY DISORDER

The authors examined the case of an adolescent patient with dissociati ve identity disorder secondary to psychological shock of a transplant rejection response. Psychiatric symptoms consisted of three components : visual hallucinations and delusions as a psychological defense again st the anxiety of a transplant rejection; appearance of three personal ities including proper self the dead child (donor), and a prophet with strong predicting power; and a twilight state. These psychiatric symp toms may have been related to two psychological factors: immature pers onality characteristics formed during hemodialysis, and post-traumatic stress caused by a chronic rejection reaction front the patient's fir st transplant.