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Journal of Psychopharmacology (Oxford,... Feb 2021Ketamine produces significant rapid-onset and robust antidepressant effects in patients with major depressive disorder. However, this drug also has transient... (Clinical Trial)
Clinical Trial
BACKGROUND
Ketamine produces significant rapid-onset and robust antidepressant effects in patients with major depressive disorder. However, this drug also has transient cardiovascular stimulatory effects, and there are limited data about potential predictors of these cardiovascular effects.
METHODS
A total of 135 patients with unipolar and bipolar depression received a total of 741 ketamine infusions (0.5 mg/kg over 40 min). Blood pressure and pulse were monitored every 10 min during the infusions and 30 min after the infusions. Depressive, psychotomimetic and dissociative symptom severity was assessed at baseline and 4 hours after each infusion.
RESULTS
The maximum blood pressure and pulse values were observed at 30-40 min during infusions. The largest mean systolic/diastolic blood pressure increases were 7.4/6.0 mmHg, and the largest mean pulse increase was 1.9 beats per min. No significant change in blood pressure and pulse was found in the second to sixth infusions compared with the first infusion. Patients who were older (age⩾50 years), hypertensive and receiving infusions while exhibiting dissociative symptoms showed greater maximal changes in systolic and diastolic blood pressure than patients who were younger (age<50 years), normotensive and without dissociative symptoms (all < 0.05). Hypertensive patients had less elevation of pulse than normotensive patients ( < 0.05). Ketamine dosage was positively correlated with changes in systolic and diastolic blood pressure (all < 0.05).
CONCLUSIONS
Blood pressure and pulse elevations following subanaesthetic ketamine infusions are transient and do not cause serious cardiovascular events. Older age, hypertension, large ketamine dosage and dissociative symptoms may predict increased ketamine-induced cardiovascular effects.
Topics: Antidepressive Agents; Bipolar Disorder; Blood Pressure; Cardiovascular System; Depressive Disorder, Major; Dissociative Disorders; Female; Humans; Infusions, Intravenous; Ketamine; Male; Middle Aged
PubMed: 32720857
DOI: 10.1177/0269881120936909 -
Journal of Child Sexual Abuse 2022Various authors have argued that dissociative amnesia is a synonym for repressed memories, recovered memories are almost always false memories, and dissociative amnesia...
Various authors have argued that dissociative amnesia is a synonym for repressed memories, recovered memories are almost always false memories, and dissociative amnesia and dissociative identity disorder are not valid disorders. These authors commit numerous errors of logic and scholarship; they misunderstand Freud's thinking about childhood sexual abuse, dissociation and repression and blame both Freudian repression theory and Freudian therapists for an epidemic of false memories. In fact, however, Freudian repression theory is based on the assumption that the childhood sexual abuse never happened. Extreme skeptics about dissociative amnesia do not understand they are actually in agreement with Freudian repression theory. These errors and other failures of logic and scholarship are analyzed and critiqued in the present paper.
Topics: Amnesia; Child; Child Abuse, Sexual; Dissociative Disorders; Freudian Theory; Humans; Repression, Psychology
PubMed: 35438615
DOI: 10.1080/10538712.2022.2067095 -
Journal of Trauma & Dissociation : the... 2023After the changes in DSM-5, dissociative subtype was added to post-traumatic stress disorder. That caused a necessity for a scale to measure the mentioned change. A...
After the changes in DSM-5, dissociative subtype was added to post-traumatic stress disorder. That caused a necessity for a scale to measure the mentioned change. A scale named Dissociative Subtype of Post-Traumatic Stress Disorder (DSPS) was developed to measure this subtype and help the diagnosis. The purpose of this study is to adapt the Dissociative Subtype of Post-Traumatic Stress Disorder to Turkish and examine its reliability and validity. The Dissociative Subtype of PTSD (DSPS) was translated into Turkish. DSPS, Turkish forms of The Posttraumatic Diagnostic Scale and Dissociative Experiences Scale were sent to participants via Google Forms and data from 279 people aged 18-45 were analyzed. Reliability tests and factor analysis were conducted. Factor analysis showed that scale has good model fit scores and items were loaded to the factors the same as the original study. Scales internal consistency was examined, and a good score was obtained (α=.84). Fit index values of confirmatory factor analysis were found as χ2/df = 2.51, GFI=.90, RMSEA=.07, RMR=.02. As a result of the high reliability scores and sufficient model fit scores, this scale is considered as a dependable measure to evaluate the dissociative subtype of PTSD.
Topics: Humans; Stress Disorders, Post-Traumatic; Reproducibility of Results; Dissociative Disorders; Diagnostic and Statistical Manual of Mental Disorders; Depersonalization
PubMed: 36994469
DOI: 10.1080/15299732.2023.2195396 -
The Journal of Nervous and Mental... Feb 2021Both borderline personality features and dissociative symptoms have been associated with different types of childhood trauma. The aim of this investigation was to...
Both borderline personality features and dissociative symptoms have been associated with different types of childhood trauma. The aim of this investigation was to analyze to what extent emotional, physical, and sexual child maltreatment predict borderline personality features and dissociative symptoms. For this purpose, we analyzed data from 86 consecutively admitted patients who completed the Borderline Symptom List, the Childhood Trauma Questionnaire, and the German version of the Dissociative Experiences Scale for differential diagnosis of a borderline personality disorder. Hierarchical regression analyses revealed that borderline features were mainly predicted by emotional abuse, whereas pathological dissociation was best predicted by sexual and physical abuse. This evidence supports the hypothesis that different kinds of maltreatment may lead to different psychopathological symptoms in adulthood and should be taken into account in the therapy.
Topics: Adult; Adult Survivors of Child Abuse; Borderline Personality Disorder; Child; Child Abuse; Child Abuse, Sexual; Dissociative Disorders; Female; Humans; Male; Psychiatric Status Rating Scales; Regression Analysis; Surveys and Questionnaires
PubMed: 33208712
DOI: 10.1097/NMD.0000000000001270 -
European Journal of Psychotraumatology 2023Recent studies found that post-traumatic and dissociative symptoms are common in people with depressive symptoms. Although a trauma-related subtype of depression has...
BACKGROUND
Recent studies found that post-traumatic and dissociative symptoms are common in people with depressive symptoms. Although a trauma-related subtype of depression has been proposed, little is known about the persistence and clinical consequences of these symptoms.
OBJECTIVE
This one-year follow-up study investigated the persistence and clinical consequences of post-traumatic and dissociative symptoms in people with depressive symptoms.
METHODS
We analyzed longitudinal data from an international sample of people self-reporting depressive emotions ( = 152) (mean Patient Health Questionnaire-9 score = 17.27; SD = 6.31).
RESULTS
More than half (58.4%) of participants with baseline post-traumatic stress disorder (PTSD) still met the criteria for PTSD after one year. Participants with dissociative symptoms at baseline were significantly more likely to report lifetime psychiatric hospitalization (31.2% vs 14.7%), past-year use of psychiatric hospitalization (10.4% vs 0%) and emergency services (16.9% vs 4%) than those without dissociative symptoms. All post-traumatic and dissociative symptom clusters were cross-sectionally ( = .286 to .528, < .001) and longitudinally ( = .181 to .462, < .001) correlated with depressive symptoms. A sense of current threat ( = .146, < .05) and negative self-concept ( = .173, < .05) at baseline significantly predicted depressive symptoms after one year.
CONCLUSIONS
These findings contribute to the increasing body of knowledge regarding the PTSD/dissociation-depression comorbidity. Given their persistence and clinical consequences, we recommend that post-traumatic and dissociative symptoms be regularly screened for in clinical settings. The existence of a possible trauma-related subtype of depression should receive more attention in both research and clinical practice.
Topics: Humans; Follow-Up Studies; Depression; Stress Disorders, Post-Traumatic; Comorbidity; Dissociative Disorders
PubMed: 37818716
DOI: 10.1080/20008066.2023.2263314 -
Epilepsy & Behavior : E&B May 2020Nonepileptic attack disorder (NEAD) and functional movement disorder (FMD) are functional neurological disorders commonly seen in neuropsychiatry services. Although...
Nonepileptic attack disorder (NEAD) and functional movement disorder (FMD) are functional neurological disorders commonly seen in neuropsychiatry services. Although their initial referral pathways involve epileptologists (NEAD) and specialists in movement disorders (FMD), these conditions are currently classified as two possible manifestations of a single underlying conversion disorder. We set out to compare the characteristics of patients with NEAD and patients with FMD in order to quantify the degree of overlap between these patient groups. We retrospectively reviewed comprehensive clinical data from 146 consecutive patients with functional neurological disorders (NEAD: n = 117; FMD: n = 29) attending a specialist Neuropsychiatry Clinic run by a single Consultant in Behavioral Neurology. The two clinical groups were directly compared with regard to demographic and clinical characteristics, as well as somatic and psychiatric presentations. The results showed that in most features, there were no significant differences between patients with NEAD and patients with FMD. However, patients with NEAD reported an earlier age at onset (p = 0.033) and a higher proportion of acute onset (p = 0.037), alterations of consciousness (p = 0.001), and headache (p = 0.042), whereas patients with FMD reported a higher prevalence of childhood abuse (p = 0.008), as well as mobility problems (p = 0.007) and comorbid functional symptoms (dysarthria, p = 0.004; dizziness, p = 0.035; weakness, p = 0.049). Despite different phenotypic presentations, NEAD and FMD might represent a clinical continuum, with relevant implications in terms of both diagnostic strategies and treatment approaches.
Topics: Adult; Conversion Disorder; Disease Progression; Dissociative Disorders; Female; Follow-Up Studies; Humans; Male; Middle Aged; Movement Disorders; Psychophysiologic Disorders; Retrospective Studies; Seizures
PubMed: 32203928
DOI: 10.1016/j.yebeh.2020.107028 -
European Journal of Psychotraumatology 2022The overlapping symptoms of schizophrenia and dissociation have been increasingly recognized. This paper explains why it is reasonable to expect that there would be a...
The overlapping symptoms of schizophrenia and dissociation have been increasingly recognized. This paper explains why it is reasonable to expect that there would be a substantial subgroup of patients diagnosed with schizophrenia spectrum disorders (SSDs) who suffer from pathological dissociation. As little is known about the prevalence of dissociative disorders and symptoms among patients with SSDs, we investigated the prevalence of dissociative disorders and symptoms among patients with SSDs. We used both self-report measures and structured interviews to examine dissociative disorders and symptoms in a randomly recruited sample of inpatients with a clinical diagnosis of SSDs in Taiwan ( = 100). Over 60% of participants exhibited pathological dissociation, and 54% had a dissociative disorder according to structured interview data; three participants met the DSM-5 diagnostic criteria for dissociative identity disorder. The concurrent validity of pathological dissociation in this sample was similar to that of depression among patients with schizophrenia reported in the literature. Participants with a dissociative disorder were more likely to report high-betrayal traumas and meet DSM-5 criteria for post-traumatic stress disorder; they also reported more psychotic symptoms than those without a dissociative disorder. This was one of very few studies that used structured interviews to examine pathological dissociation in patients with SSDs. The results indicate that pathological dissociation in SSDs is not uncommon. Clinical assessment should include measures of dissociation to facilitate early identification.
Topics: Dissociative Disorders; Humans; Inpatients; Psychotic Disorders; Schizophrenia; Taiwan
PubMed: 35979506
DOI: 10.1080/20008066.2022.2105576 -
The Journal of Nervous and Mental... Mar 2024Dissociative identity disorder (DID) has historically been one of the most controversial topics in the study of psychopathology. Building on a previous review of... (Review)
Review
Dissociative identity disorder (DID) has historically been one of the most controversial topics in the study of psychopathology. Building on a previous review of empirical research on DID from 2000 to 2010, the present review examined DID research from 2011 to 2021. The research output included 56 case studies and 104 empirical studies. Within the empirical studies, approximately 1354 new cases of DID emerged, which resulted in an average samples of approximately 20. Reanalysis of previous samples was standard in the literature with only 40% of reported cases being new. Studies emerged from dozens of countries across the world, but the majority of cases were from Western counties, especially the United States. Diagnosis primarily relied upon validated measures, but 74% of all new cases came from six research groups. Overall, research on DID is steady but methodologically limited in ways that make generalization, especially about etiology, difficult.
Topics: Humans; Dissociative Identity Disorder; Dissociative Disorders
PubMed: 38412243
DOI: 10.1097/NMD.0000000000001764 -
European Journal of Psychotraumatology 2022We present a case study of the remission of a chemically resistant schizophrenia disorder after a single session of EMDR. Our patient had been followed-up for...
We present a case study of the remission of a chemically resistant schizophrenia disorder after a single session of EMDR. Our patient had been followed-up for schizophrenia according to DSM5 criteria, since 4 years. During our subject's fourth hospitalization for major delirious decompensation, a single EMDR session, according to the standard protocol, resulted in a complete and total remission of the delirious disorder and the disorganization/dissociative syndrome in 8 weeks. This allowed us to interrupt the patient's antipsychotic treatment without relapse at 18 months. This case study allows us to highlight, as many authors have previously done, the necessity of researching the traumatic history of patients diagnosed with schizophrenia in order to provide therapies focused on traumatic dissociation. It also questions the relevance of our diagnostic criteria for schizophrenia and other dissociative disorders.
Topics: Adult; Antipsychotic Agents; Clozapine; Dissociative Disorders; Eye Movement Desensitization Reprocessing; Humans; Male; Remission, Spontaneous; Schizophrenia, Treatment-Resistant
PubMed: 35140878
DOI: 10.1080/20008198.2021.2014660 -
Scandinavian Journal of Psychology Apr 2023Dissociation is a complex phenomenon which is present in a wide variety of psychiatric disorders and also in the general population. The objective of this study was to...
Dissociation is a complex phenomenon which is present in a wide variety of psychiatric disorders and also in the general population. The objective of this study was to examine the relationship between childhood and adolescent traumas and development of dissociative phenomena in a nonclinical population, emphasizing the potentially mediating role of rumination, intrusive thoughts and negative affect in a population with no psychiatric pathology in adulthood. The sample was comprised of 337 participants from the general population (58.8% women) with a mean age of 33.10 years (SD: 14.08). They completed the Juvenile Victimization Questionnaire (JVQ), the Ruminative Response Scale (RRS), the White Bear Suppression Scale (WBSI), the Dissociative Experience Scale, 2d ver. Rev. (DES-II) and the Depression, Anxiety and Stress Scale (DASS-21). The results supported the starting hypotheses showing a positive correlation between childhood and adolescent trauma and dissociation, and between childhood and adolescent trauma and rumination, intrusive thoughts and negative affect, and mediation of these variables between childhood and adolescent trauma and dissociative states. The relationship between trauma in early ages and dissociation in adulthood is complex. Although the design used in this study was cross-sectional, the results are compatible with the starting hypothesis that rumination, intrusive thoughts and negative affect mediate this relationship.
Topics: Adolescent; Humans; Child; Female; Adult; Male; Adverse Childhood Experiences; Cross-Sectional Studies; Anxiety; Dissociative Disorders; Affect
PubMed: 36240326
DOI: 10.1111/sjop.12879