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Zhurnal Nevrologii I Psikhiatrii Imeni... 2021This paper reviews the literature on functional neurological disorders (Dissociative (conversion disorders - F44). The authors present a change in views on the etiology... (Review)
Review
This paper reviews the literature on functional neurological disorders (Dissociative (conversion disorders - F44). The authors present a change in views on the etiology and the main mechanisms of the pathogenesis of this pathology during the period of its study. The modern ideas about the types of cerebral dysfunction characteristic of functional neurological disorders are considered. The description of the most characteristic mental and somatic symptoms observed in dissociative disorders and the features of their clinical manifestations are given. The current approaches to the therapy of functional neurological disorders are considered.
Topics: Brain Diseases; Conversion Disorder; Dissociative Disorders; Humans
PubMed: 33580769
DOI: 10.17116/jnevro202112101198 -
European Journal of Psychotraumatology 2023The clinical guidelines for the treatment of dissociation focus primarily on psychotherapy. However, different psychoactive drugs are used in clinical practice. The use... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The clinical guidelines for the treatment of dissociation focus primarily on psychotherapy. However, different psychoactive drugs are used in clinical practice. The use of opioid antagonists has been proposed as a therapeutic option based on the theory that dissociation might be a phenomenon mediated by dysregulation of the endogenous opioid system.
OBJECTIVE
To review and meta-analyse the available evidence on the efficacy of the opioid antagonists naltrexone, naloxone, and nalmefene as treatments for dissociative symptoms and disorders.
METHOD
The PRISMA guidelines were followed, and this review was registered in Prospero with reference number CRD42021280976. The search was performed in the PubMed, Scopus, Web of Science, EMBASE, PsycINFO, and PubPsych databases.
RESULTS
1,798 citations were obtained. After removing duplicates and applying inclusion and exclusion criteria, we included 5 comparative studies with 9 dissociation measures that had included a total of 154 participants, of whom 134 had been treated with an opioid antagonist. The results of the meta-analysis showed a treatment effect for dissociation when using opioid antagonists [pooled = 1.46 (95% CI: 0.62-2.31)]. However, the studies we included were very heterogeneous [Q = 66.89 ( < .001)] and there may have been publication bias.
CONCLUSIONS
Although more research is needed and the results must be interpreted with caution because of the limited amount of data and heterogeneity in the studies and their methodological qualities, opioid antagonists (particularly naltrexone) are promising candidates for the treatment of dissociative symptoms and showed a moderate - large effect size in reducing these symptoms.
Topics: Humans; Narcotic Antagonists; Naltrexone; Naloxone; Dissociative Disorders
PubMed: 37860852
DOI: 10.1080/20008066.2023.2265184 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2022The article provides an overview of scientific publications devoted to the study of the problem of functional cognitive disorders (FCD), which are one of the variants of... (Review)
Review
The article provides an overview of scientific publications devoted to the study of the problem of functional cognitive disorders (FCD), which are one of the variants of functional neurological disorders (FND). The authors provide data on the frequency of occurrence of this pathology, the differences between the concepts of FCD and «subjective cognitive disorders» (dissociative (conversion) disorders - F44). The authors show the traditional views on the study of this pathology in the mainstream of hysterical disorders. The modern concepts of information processing disorders as a mechanism of FCD development are considered. Special attention is paid to the role of executive dysfunction in the genesis of FCD. The descriptions of the main clinical manifestations of FCD are given. The basic principles of diagnostic examination of patients with FCD are considered. The article presents modern approaches to the therapy of FCD, with special attention paid to psychotherapeutic correction in this pathology.
Topics: Cognition; Cognition Disorders; Cognitive Dysfunction; Conversion Disorder; Dissociative Disorders; Humans
PubMed: 35271235
DOI: 10.17116/jnevro202212202143 -
Consciousness and Cognition Mar 2021Hypnotic suggestibility is part of the wider psychological trait of direct verbal suggestibility (DVS). Historically, DVS in hypnosis has informed theories of... (Review)
Review
Hypnotic suggestibility is part of the wider psychological trait of direct verbal suggestibility (DVS). Historically, DVS in hypnosis has informed theories of consciousness and of conversion disorder. More recently it has served as a research tool in cognitive science and in cognitive neuroscience in particular. Here we consider DVS as a general trait, its relation to other psychological characteristics and abilities, and to the origin and treatment of clinical conditions. We then outline the distribution of DVS in the population, its measurement, relationship to other forms of suggestibility, placebo responsiveness, personal characteristics, gender, neurological processes and other factors, such as expectancy. There is currently no scale specifically designed to measure DVS outside a hypnotic context. The most commonly used and well-researched of the hypnosis-based scales, the Harvard Group Scale, is described and identified as a basis for a more broadly based measure of DVS for use in psychological research.
Topics: Consciousness; Dissociative Disorders; Humans; Hypnosis; Suggestion
PubMed: 33556865
DOI: 10.1016/j.concog.2020.103036 -
CNS Spectrums Dec 2019Fibromyalgia (FM) is a chronic pain syndrome with a controversial etiopathogenesis. Patients with FM usually complain of cognitive symptoms, which are described as...
BACKGROUND
Fibromyalgia (FM) is a chronic pain syndrome with a controversial etiopathogenesis. Patients with FM usually complain of cognitive symptoms, which are described as "fibrofog." These cognitive complaints might be caused partially by dissociative disorders (DD). The aim of this research is to determine the association between FM and DD.
METHODS
The authors conducted a case-control study for this purpose, integrated by 3 groups: control (C), patients with rheumatic disorders (R), and patients with FM (FM), who were compared through the Dissociative Experiences Scale (DES).The findings are as follows: 42% were taking medications in the FM group, and their differences in scores with those who were not under medications were then considered. In terms of the results, the FM group showed higher scores than both C and R groups (p < 0.05). Patients with FM who were taking antidepressants had lower scores than those who were not (Z-score -8.03; p < 0.05); and finally, 5.71% had a score over 30 (χ2 = 3.73, p = 0.15).
CONCLUSION
Patients with FM had higher scores, which might be related to the association of dissociative experiences, lifetime trauma, and victimization. Antidepressants might have some role on dissociative symptoms as well.
Topics: Adult; Aged; Case-Control Studies; Dissociative Disorders; Female; Fibromyalgia; Humans; Male; Middle Aged
PubMed: 30894235
DOI: 10.1017/S1092852918001608 -
Tijdschrift Voor Psychiatrie 2021
Topics: Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Humans; Standard of Care; Stress Disorders, Post-Traumatic
PubMed: 33779970
DOI: No ID Found -
Journal of Neurology, Neurosurgery, and... Feb 2022Functional seizures (FS) known also as psychogenic non-epileptic seizures or dissociative seizures, present with ictal semiological manifestations, along with various... (Review)
Review
Functional seizures (FS) known also as psychogenic non-epileptic seizures or dissociative seizures, present with ictal semiological manifestations, along with various comorbid neurological and psychological disorders. Terminology inconsistencies and discrepancies in nomenclatures of FS may reflect limitations in understanding the neuropsychiatric intricacies of this disorder. Psychological and neurobiological processes of FS are incompletely understood. Nevertheless, important advances have been made on underlying neuropsychopathophysiological mechanisms of FS. These advances provide valuable information about the underlying mechanisms of mind-body interactions. From this perspective, this narrative review summarises recent studies about aetiopathogenesis of FS at two levels: possible risk factors (why) and different aetiopathogenic models of FS (how). We divided possible risk factors for FS into three categories, namely neurobiological, psychological and cognitive risk factors. We also presented different models of FS based on psychological and neuroanatomical understanding, multilevel models and integrative understanding of FS. This work should help professionals to better understand current views on the multifactorial mechanisms involved in the development of FS. Shedding light on the different FS profiles in terms of aetiopathogenesis will help guide how best to direct therapy, based on these different underlying mechanisms.
Topics: Comorbidity; Conversion Disorder; Diagnosis, Differential; Dissociative Disorders; Electroencephalography; Female; Humans; Male; Psychophysiologic Disorders; Risk Factors; Seizures; Sex Characteristics
PubMed: 34824146
DOI: 10.1136/jnnp-2021-326708 -
Journal of Trauma & Dissociation : the... 2023
Topics: Humans; Dissociative Disorders; Psychiatric Status Rating Scales
PubMed: 37023226
DOI: 10.1080/15299732.2023.2191240 -
Progress in Brain Research 2022Patients who display the neurological phenomena variously referred to as pseudoseizures, dissociative seizures, or psychogenic non-epileptic seizures present an... (Review)
Review
Patients who display the neurological phenomena variously referred to as pseudoseizures, dissociative seizures, or psychogenic non-epileptic seizures present an important problem in the treatment of epilepsy. Their convulsive or non-convulsive episodes show no epileptiform activity on electroencephalography but are distressing and debilitating to patients so afflicted, and can be difficult to distinguish from classical epilepsy. It is important to make this distinction, as the treatment for pseudoseizures is typically cognitive behavioral therapy rather than anticonvulsant medication. This review describes the clinical differences in the signs and symptoms of patients with pseudoseizures vs classical epileptic seizures, as well as the underlying mechanisms triggering pseudoseizures, and the outcomes achieved with the treatment paradigms currently available for them.
Topics: Conversion Disorder; Diagnosis, Differential; Dissociative Disorders; Electroencephalography; Epilepsy; Humans; Seizures
PubMed: 35667799
DOI: 10.1016/bs.pbr.2022.03.003 -
The Journal of Nervous and Mental... Sep 2020Auditory hallucinations are widely regarded as symptoms of brain disease treated with medications. In an alternative paradigm, voices are understood as trauma-driven...
Auditory hallucinations are widely regarded as symptoms of brain disease treated with medications. In an alternative paradigm, voices are understood as trauma-driven dissociated, disowned, or disavowed aspects of self; the goal is not to suppress them but to integrate them during psychotherapy. Auditory hallucinations are common in dissociative identity disorder, borderline personality disorder, and complex posttraumatic stress disorder and are not specific to psychosis. The features that differentiate psychotic from dissociative voices include the qualities of the voices themselves, as well as other symptoms: for example, compared with dissociative voices, psychotic voices are accompanied by less sociability, more formal thought disorder, more negative symptoms including blunted affect, and more delusions. The author proposes that the psychotherapy of dissociative voices can be indicated trans-diagnostically, including in a subgroup of individuals with diagnoses of schizophrenia. Psychotherapeutic strategies are illustrated with a case example.
Topics: Borderline Personality Disorder; Dissociative Disorders; Dissociative Identity Disorder; Hallucinations; Humans; Psychotherapy; Psychotic Disorders; Schizophrenia; Schizophrenic Psychology; Stress Disorders, Post-Traumatic
PubMed: 32868688
DOI: 10.1097/NMD.0000000000001206