|dc.description.abstract||A polysomnographic (PSG) and clinical study of 150 consecutive patients presenting to a sleep disorders center during a 7.5 year period for evaluation of repeated sleep-related injury (ecchymoses, lacerations, fractures) identified 5.3percent (N=8) with Dissociative Disorders (DDs) as the cause of the injuries, and whose presenting diagnosis was somnambulism. 87.5 percent (7/8) were female, and the mean age at referral was 29.5 (+/-SD 6.1) years. Two patients fulfilled DSM-111-R criteria for Multiple Personality Disorder (MPD). The six other patients were diagnosed as Dissociative Disorders Not Otherwise Specified, but were strongly suspected to have MPD. One patient had an exclusively nocturnal, animalistic DD: a 19 year old male who had acted like a large jungle cat twice weekly for 4 years.
PSG studies were diagnostic for nocturnal DD in 50 percent (4/8) of the cases (including that of the jungle cat), with distinctly altered, complex, repetitive and lengthy behaviors emerging suddenly from sustained electroencephalographic wakefulness. PSG studies supported the diagnosis of DD as the cause of nocturnal injury in the other 50 percent (4/8) of the cases: i) by not detecting seizure activity, NREM/REM sleep motor abnormality or sleep breathing disturbance, and ii) when correlated with the clinical history of chronic daytime DDs.||en