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Comprehensive Psychiatry Oct 2012The present study attempted to assess the dissociative symptoms and overall dissociative disorder comorbidity in patients with obsessive-compulsive disorder (OCD). In...
The present study attempted to assess the dissociative symptoms and overall dissociative disorder comorbidity in patients with obsessive-compulsive disorder (OCD). In addition, we examined the relationship between the severity of obsessive-compulsive symptoms and dissociative symptoms. All patients admitted for the first time to the psychiatric outpatient unit were included in the study. Seventy-eight patients had been diagnosed as having OCD during the 2-year study period. Patients had to meet the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD. Most (76.9%; n = 60) of the patients were female, and 23.1% (n = 18) of the patients were male. Dissociation Questionnaire was used to measure dissociative symptoms. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Dissociative Disorders interviews and Yale-Brown Obsessive Compulsive Checklist and Severity Scale were used. Eleven (14%) of the patients with OCD had comorbid dissociative disorder. The most prevalent disorder in our study was dissociative depersonalization disorder. Dissociative amnesia and dissociative identity disorder were common as well. The mean Yale-Brown score was 23.37 ± 7.27 points. Dissociation Questionnaire scores were between 0.40 and 3.87 points, and the mean was 2.23 ± 0.76 points. There was a statistically significant positive correlation between Yale-Brown points and Dissociation Questionnaire points. We conclude that dissociative symptoms among patients with OCD should alert clinicians for the presence of a chronic and complex dissociative disorder. Clinicians may overlook an underlying dissociative process in patients who have severe symptoms of OCD. However, a lack of adequate response to cognitive-behavioral and drug therapy may be a consequence of dissociative process.
Topics: Adolescent; Adult; Comorbidity; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Female; Humans; Interview, Psychological; Male; Middle Aged; Obsessive-Compulsive Disorder; Surveys and Questionnaires
PubMed: 22425531
DOI: 10.1016/j.comppsych.2012.02.004 -
Journal of Trauma & Dissociation : the... 2014Dissociative amnesia (DA) among subjects with a dissociative disorder and/or borderline personality disorder (BPD) recruited from a nonclinical population was examined....
Dissociative amnesia (DA) among subjects with a dissociative disorder and/or borderline personality disorder (BPD) recruited from a nonclinical population was examined. The Steinberg Dissociative Amnesia Questionnaire (SDAQ), the Childhood Trauma Questionnaire, and the self-report screening tool of the BPD section of the Structured Clinical Interview for DSM-IV(SCID-BPD) were administered to 1,301 college students. A total of 80 participants who were diagnosed with BPD according to the clinician-administered SCID-BPD and 111 nonborderline controls were evaluated using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) by a psychiatrist blind to diagnosis and scale scores. Internal consistency analyses and test-retest evaluations suggested that the SDAQ is a reliable instrument for the population studied. Of the participants, 20.6% reported an SDAQ score of 20 or above and impairment by DA. Those who had both dissociative disorder and BPD (n = 78) had the highest SDAQ scores. Both disorders had significant effects on the SCID-D total and amnesia scores in the variance analysis. On SDAQ scores, however, only BPD had this effect. There was a significant interaction between the 2 disorders for the SCID-D total but not for the SDAQ or SCID-D amnesia scores. BPD represented the severity of dissociation and childhood trauma in this study group. However, in contrast to the dissociative disorders, BPD was characterized by better awareness of DA in self-report. The discrepancies between self-report and clinical interview associated with BPD and dissociative disorders are discussed in the context of betrayal theory (J. J. Freyd, 1994) of BPD and perceptual theory (D. B. Beere, 2009) of dissociative disorders.
Topics: Adolescent; Adult; Adult Survivors of Child Abuse; Amnesia; Borderline Personality Disorder; Dissociative Disorders; Female; Humans; Interview, Psychological; Male; Psychiatric Status Rating Scales; Self Disclosure; Students; Surveys and Questionnaires; Turkey
PubMed: 24678926
DOI: 10.1080/15299732.2014.902415 -
Seishin Shinkeigaku Zasshi =... 2011Both the number of patients with dissociative disorder and that of those with self-injury have been increasing since the end of the twentieth century, suggesting that... (Review)
Review
Both the number of patients with dissociative disorder and that of those with self-injury have been increasing since the end of the twentieth century, suggesting that dissociation and self-injury might be closely related. When dissociative disorder coexists with self-injury, it implies self-punishment and a wish to be understood by others. Although many cases of self-injury observed since 2000 lacked traumatic experiences and were not accompanied by pathological dissociative symptoms, the patients did have dissociative tendencies. According to the results of our study examining self-injury in patients with eating disorders, we observed that self-injury, dissociative tendency and insulation from others are related to each other. This suggests that affects, sensations and representations are dissociated, losing their normal response order, and that the pervasive idea that "pain=secure" is formed in a patient from childhood based on influence from their parents. Self-injury appears to be an activation of this pervasive idea that is triggered by a stressful situation, when the dissociative psychological segmentation of effects and their representations are present in the background.
Topics: Adolescent; Adult; Dissociative Disorders; Feeding and Eating Disorders; Female; Humans; Psychopathology; Self-Injurious Behavior
PubMed: 22117397
DOI: No ID Found -
Clinical Psychology Review Jun 2001We review the empirical evidence for the validity of the Dissociative Identity Disorder (DID) diagnosis, the vast majority of which has come from research conducted... (Review)
Review
We review the empirical evidence for the validity of the Dissociative Identity Disorder (DID) diagnosis, the vast majority of which has come from research conducted within the last 10 years. After reviewing three different guidelines to establish diagnostic validity, we conclude that considerable converging evidence supports the inclusion of DID in the current Diagnostic and Statistical Manual for Mental Disorders. For instance, DID appears to meet all of the guidelines for inclusion and none of the exclusion guidelines; proposed by Blashfield et al. [Comprehensive Psychiatry 31 (1990) 15-19], and it is one of the few disorders currently supported by taxometric research. However, we also discuss possible problems with the current diagnostic criteria and offer recommendations, based on recent research, for possible revisions to these criteria.
Topics: Adult; Bias; Child; Dissociative Disorders; Humans; Personality Assessment; Personality Disorders; Practice Guidelines as Topic; Psychiatric Status Rating Scales; Reproducibility of Results
PubMed: 11413868
DOI: 10.1016/s0272-7358(99)00073-2 -
The American Journal of Psychiatry Aug 1997
Topics: Clinical Competence; Cross-Cultural Comparison; Dissociative Disorders; Dissociative Identity Disorder; Humans; Incidence; Psychiatric Status Rating Scales; Psychometrics; Terminology as Topic; Turkey
PubMed: 9247428
DOI: 10.1176/ajp.154.8.1179a -
Genes May 2022Dissociative disorders are a common and frequently undiagnosed group of psychiatric disorders, characterized by disruptions in the normal integration of awareness,... (Review)
Review
Dissociative disorders are a common and frequently undiagnosed group of psychiatric disorders, characterized by disruptions in the normal integration of awareness, personality, emotion and behavior. The available evidence suggests that these disorders arise from an interaction between genetic vulnerability and stress, particularly traumatic stress, but the attention paid to the underlying genetic diatheses has been sparse. In this paper, the existing literature on the molecular genetics of dissociative disorders, as well as of clinically significant dissociative symptoms not reaching the threshold of a disorder, is reviewed comprehensively across clinical and non-clinical samples. Association studies suggest a link between dissociative symptoms and genes related to serotonergic, dopaminergic and peptidergic transmission, neural plasticity and cortisol receptor sensitivity, particularly following exposure to childhood trauma. Genome-wide association studies have identified loci of interest related to second messenger signaling and synaptic integration. Though these findings are inconsistent, they suggest biologically plausible mechanisms through which traumatic stress can lead to pathological dissociation. However, methodological concerns related to phenotype definition, study power, and correction for the confounding factors limit the value of these findings, and they require replication and extension in studies with better design.
Topics: Dissociative Disorders; Emotions; Genome-Wide Association Study; Humans; Molecular Biology
PubMed: 35627228
DOI: 10.3390/genes13050843 -
Journal of Child Sexual Abuse Jul 2022The authors interviewed 118 highly dissociative inpatients in a Trauma Program with the Dissociative Disorders Interview Schedule, the Dissociative Experiences Scale and...
The authors interviewed 118 highly dissociative inpatients in a Trauma Program with the Dissociative Disorders Interview Schedule, the Dissociative Experiences Scale and the Adverse Childhood Experiences questionnaire; of the 118 participants 42 met DSM-5 criteria for dissociative identity disorder and 52 for other specified dissociative disorder. The average score on the Dissociative Experiences Scale in the sample of 118 participants was 44.7. The authors also conducted semi-structured interviews inquiring about the circumstances and triggers for reversal of amnesia for childhood trauma in the participants. Only a small minority of the reversal of amnesia took place in therapy sessions, and 24 different triggers for remembering were described. Childhood sexual abuse was by far the most common type of trauma for which amnesia was reversed. The findings are inconsistent with the view that amnesia for childhood sexual abuse is reversed primarily during psychotherapy.
Topics: Amnesia; Child; Child Abuse, Sexual; Dissociative Disorders; Dissociative Identity Disorder; Humans; Inpatients; Psychiatric Status Rating Scales
PubMed: 35437119
DOI: 10.1080/10538712.2022.2067096 -
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 -
Neurology India 2022Movement disorders are common presentations to psychiatry and neurology clinics in general hospitals. Many a times, liaison between psychiatry and neurology helps in...
Movement disorders are common presentations to psychiatry and neurology clinics in general hospitals. Many a times, liaison between psychiatry and neurology helps in determining the exact etiology and diagnosis of rare movement disorders. Paroxysmal dyskinesia is a group of disorders caused by a genetic mutation. It is one of the rare presentations among dyskinetic disorders but often encountered by psychiatrists due to the psychogenic nature of episodes and apparently normal neurological findings in-between the episodes. Liaison work with a neurologist is of great importance rather than misdiagnosing them as a dissociative or psychogenic movement disorder. Unawareness of their presentation can lead to repeated consultations, unwarranted psychotherapies, and can create a sense of therapeutic nihilism among the treating psychiatrists. Predominantly four different variants are described in the literature under this group and new classification has been proposed recently. We encountered a case of paroxysmal kinesigenic dyskinesia with obstructive sleep apnea masquerading as a dissociative disorder.
Topics: Chorea; Dissociative Disorders; Dystonia; Humans; Mutation
PubMed: 35263924
DOI: 10.4103/0028-3886.338710 -
Psychopathology 2019Delusional disorder (DD) is still considered a diagnosis of exclusion for a difficult-to-treat condition characterised by the presence of delusional beliefs in the...
Delusional disorder (DD) is still considered a diagnosis of exclusion for a difficult-to-treat condition characterised by the presence of delusional beliefs in the absence of other psychiatric symptoms. Attempts to contextualise psychological processes recognised since the earliest observations of this disorder have had very limited impact on improving some fixed beliefs. In the Cambridge Early Intervention in Psychosis Service we have observed a particular phenomenon, often categorised as a delusional idea in the context of DD, which manifests through highly repetitive belief expression that fails to respond to pharmacological and psychological treatments. Key aspects of this phenomenon are similar to those observed in dissociative (functional neurological) presentations. Drawing on the Integrative Cognitive Model of functional neurological disorders, we developed a successful psychological intervention that places less emphasis on challenging delusional content and focuses more on dismantling dissociation and underlying affective factors associated with the activation of the fixed belief. Our initial findings reinforce the need to continue developing a multi-level phenomenological approach to define a variety of symptoms traditionally grouped under the concept of "delusion."
Topics: Delusions; Dissociative Disorders; Female; Humans; Middle Aged; Schizophrenia, Paranoid
PubMed: 31085924
DOI: 10.1159/000499596