What happens to people who have dissociative identity disorder?

The life course is variable and the illness is often prolonged. This disorder almost always begins in childhood, although it may not become apparent to others or to the patient until a later age. The disorder may be less troublesome past the late forties, but may reemerge during times of stress or trauma or with substance abuse. This disorder is far more common in women than in men. The degree of impairment ranges from mild to severe, and complications may include suicide attempts, self-mutilation, violence, or drug abuse. There has been no systematic study of long-term outcome in this disorder.