Dissociative identity disorder (DID) in Japan: A forensic case report and the recent increase in reports of DID.

The subject of this report murdered four young girls between 1988 and 1989. The forensic psychiatric evaluation showed that soon after the sudden death of his dearest grandfather he had developed dissociative symptoms including depersonalization, autoscopy, fugue, dissociative amnesia, Ganser's syndrome and DID, on the basis of earlier traumatic experiences under the dysfunctional family circumstances of his early childhood. His DID was thought to be manifest in at least four personalities, i.e., a host personality, a child personality, a cool personality and a female personality. In Japan only five cases of DID were reported between 1919 and 1990, whereas more than 30 cases were reported in journals or at academic meetings from 1991 to 1997. Although the incidence is still quite low in Japan, DID can be considered to be a valid clinical entity in spite of Merskey's severe criticism of the disorder. (Int J Psych Clin Pract 2000; 4:155-160).