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Journal of the College of Physicians... Feb 2009To determine the frequency distribution of various types of dissociative disorders, along with existing co-morbid depression and its level of severity in patients with...
OBJECTIVE
To determine the frequency distribution of various types of dissociative disorders, along with existing co-morbid depression and its level of severity in patients with dissociative disorder.
STUDY DESIGN
Observational, cross-sectional study.
PLACE AND DURATION OF STUDY
The Institute of Psychiatry, Rawalpindi General Hospital from October 2004 to March 2005.
METHODOLOGY
Fifty consecutive patients were included in the study through non-probable purposive sampling technique. Encounter form included socio-demographic profile and brief psychiatric history. ICD 10 diagnostic criteria for research were administered for determining the presentation of dissociative disorder. Present state examination was applied to make diagnosis of depressive disorder in the studied patients. Descriptive statistics for frequency analysis of sociodemographic variables, type of presentation of dissociative disorder and the frequency of depressive disorder in patients of dissociative disorder.
RESULTS
The mean age was 23.6+/-8.67 years with female preponderance (n=40, 80% patients). Most of them were single, unemployed and belonged to urban population. Main stress was primary support group issue. Mixed category of dissociative disorder was highest (n=18, 38%) followed by unspecified and motor symptoms (n=13, 26%) in each group. Depression was present in 42 (84%) patients. Moderate depression was most frequent (n=19, 38%).
CONCLUSION
Mixed dissociative symptoms were found in 38%, while 26% had motor and unspecified category of dissociative symptoms respectively. Depressive disorder was present in 42 (84%) cases of dissociative disorder with 38% having moderate depression.
Topics: Adolescent; Adult; Child; Comorbidity; Conversion Disorder; Cross-Sectional Studies; Depressive Disorder; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Female; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Severity of Illness Index; Sex Factors; Socioeconomic Factors; Surveys and Questionnaires; Young Adult
PubMed: 19208316
DOI: No ID Found -
The Permanente Journal 2020People who live with dissociative disorders and a history of childhood trauma are less rare than commonly thought and can be challenging for unfamiliar medical...
People who live with dissociative disorders and a history of childhood trauma are less rare than commonly thought and can be challenging for unfamiliar medical practitioners. Many of us present as apparently normal people and live full and satisfying lives. But under the stress of a medical situation, we can become unpredictable. On the basis of my own experiences, I offer, in this article, some instructive anecdotes and tips for health care practitioners on how to work with patients with a trauma-related diagnosis such as a dissociative disorder.
Topics: Adult Survivors of Child Abuse; Aged; Dissociative Disorders; Female; Humans
PubMed: 31852054
DOI: 10.7812/TPP/19.094 -
Clinical Pediatrics Mar 2022
Topics: Adolescent; Autism Spectrum Disorder; Dissociative Disorders; Humans; Male
PubMed: 35037485
DOI: 10.1177/00099228211069724 -
Journal of Trauma & Dissociation : the... 2015The 1st objective of the current study was to investigate the frequency and types of dissociative symptoms in patients with conversion disorder (CD). The 2nd objective...
The 1st objective of the current study was to investigate the frequency and types of dissociative symptoms in patients with conversion disorder (CD). The 2nd objective of the current study was to determine psychiatric comorbidity in patients with and without dissociative symptoms. A total of 54 consecutive consenting patients primarily diagnosed with CD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria who were admitted to the psychiatric emergency outpatient clinic of Sisli Etfal Research and Teaching Hospital (Istanbul, Turkey) were included in the study. The Structured Clinical Interview for DSM-IV Axis I Disorders, Structured Interview for DSM-IV Dissociative Disorders, and Dissociative Experiences Scale were administered. Study groups consisted of 20 patients with a dissociative disorder and 34 patients without a diagnosis of any dissociative disorder. A total of 37% of patients with CD had any dissociative diagnosis. The prevalence of dissociative disorders was as follows: 18.5% dissociative disorder not otherwise specified, 14.8% dissociative amnesia, and 3.7% depersonalization disorder. Significant differences were found between the study groups with respect to comorbidity of bipolar disorder, past hypomania, and current and past posttraumatic stress disorder (ps = .001, .028, .015, and .028, respectively). Overall comorbidity of bipolar disorder was 27.8%. Psychiatric comorbidity was higher and age at onset was earlier among dissociative patients compared to patients without dissociative symptoms. The increased psychiatric comorbidity and early onset of conversion disorder found in patients with dissociative symptoms suggest that these patients may have had a more severe form of conversion disorder.
Topics: Adult; Comorbidity; Conversion Disorder; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Female; Humans; Interview, Psychological; Male; Prevalence; Turkey
PubMed: 25365395
DOI: 10.1080/15299732.2014.938214 -
Annual Review of Clinical Psychology May 2022For more than 30 years, the posttraumatic model (PTM) and the sociocognitive model (SCM) of dissociation have vied for attention and empirical support. We contend that... (Review)
Review
For more than 30 years, the posttraumatic model (PTM) and the sociocognitive model (SCM) of dissociation have vied for attention and empirical support. We contend that neither perspective provides a satisfactory account and that dissociation and dissociative disorders (e.g., depersonalization/derealization disorder, dissociative identity disorder) can be understood as failures of normally adaptive systems and functions. We argue for a more encompassing transdiagnostic and transtheoretical perspective that considers potentially interactive variables including sleep disturbances; impaired self-regulation and inhibition of negative cognitions and affects; hyperassociation and set shifts; and deficits in reality testing, source attributions, and metacognition. We present an overview of the field of dissociation, delineate uncontested and converging claims across perspectives, summarize key multivariable studies in support of our framework, and identifyempirical pathways for future research to advance our understanding of dissociation, including studies of highly adverse events and dissociation.
Topics: Dissociative Disorders; Humans; Metacognition; Stress Disorders, Post-Traumatic
PubMed: 35226824
DOI: 10.1146/annurev-clinpsy-081219-102424 -
Bulletin of the Menninger Clinic 2000The standard of care for the delivery of mental health services has recently undergone a dramatic change spurred on by hundreds of lawsuits against therapists and by... (Review)
Review
The standard of care for the delivery of mental health services has recently undergone a dramatic change spurred on by hundreds of lawsuits against therapists and by erupting controversies in the science of trauma and dissociative disorders. The nature of these changes and the forces that created them are discussed. Risk management suggestions are provided.
Topics: Disasters; Dissociative Disorders; Humans; Malpractice; Psychotherapy; Quality Assurance, Health Care; Stress Disorders, Post-Traumatic; Survivors
PubMed: 10842448
DOI: No ID Found -
Epilepsy & Behavior : E&B Dec 2013Dissociative seizures are commonly recognized as both a challenging and a poorly understood condition. Though research and publication activity is high, advances in... (Review)
Review
Dissociative seizures are commonly recognized as both a challenging and a poorly understood condition. Though research and publication activity is high, advances in knowledge and insight seem only moderate in recent years. This review focuses on some relevant problematic issues, which might account for a still unsatisfactory research state. A general tendency to deal with dissociative seizures as an assumed disorder in its own nosological right and not as a sole symptom of an underlying psychiatric disorder is most likely one of the major roots of the problem. Unfavorable impacts of this confusion pertaining to clinical management, therapy, and outcome of dissociative seizures are discussed. An alternative point of view, based on the immanent psychiatric and psychodynamic roots of dissociative seizures, is considered.
Topics: Conversion Disorder; Dissociative Disorders; Humans; Psychophysiologic Disorders; Seizures
PubMed: 24090778
DOI: 10.1016/j.yebeh.2013.08.018 -
Journal of Trauma & Dissociation : the... 2019The dissociative disorders field and the hypnosis field currently reject the autohypnotic model of the dissociative disorders, largely because many correlational studies... (Review)
Review
The dissociative disorders field and the hypnosis field currently reject the autohypnotic model of the dissociative disorders, largely because many correlational studies have shown hypnotizability and dissociation to be minimally related ( = .12). Curiously, it is also widely accepted that dissociative patients are highly hypnotizable. If dissociative patients are highly hypnotizable because - as the author proposes - then the methodology of correlational studies of hypnotizability and dissociation in random clinical and community samples would necessarily be constitutively unable to detect, and statistically unable to reflect, that fact. That is, the autohypnotic, dissociative distancing of that small subset of highly hypnotizable individuals who repeatedly encountered intolerable circumstances is statistically lost among the data of (1) the highly hypnotizable subjects who do not dissociate and (2) subjects (of all levels of hypnotizability) who manifest kinds of dissociation. The author proposes that, when highly hypnotizable individuals repeatedly engage in autohypnotic distancing from intolerable circumstances, they develop an overlearned, highly-motivated, automatized pattern of dissociative self-protection (i.e., a dissociative disorder). The author urges that theorists of hypnosis and the dissociative disorders explicitly include in their theories (a) the trait of high hypnotizability, (b) the phenomena of autohypnosis, and (c) the manifestations of systematized, autohypnotic pathology. Said differently, the author is suggesting that autohypnosis and autohypnotic pathology are unacknowledged nodes in the nomothetic networks of both hypnosis and dissociation.
Topics: Dissociative Disorders; Humans; Hypnosis; Models, Psychological
PubMed: 29565750
DOI: 10.1080/15299732.2018.1451806 -
Comprehensive Psychiatry May 2014The relatively high prevalence of the diagnosis of dissociative disorder not otherwise specified is frequently considered to be disproportionate. The disproportionate...
The relatively high prevalence of the diagnosis of dissociative disorder not otherwise specified is frequently considered to be disproportionate. The disproportionate rate of this diagnosis is thought to be related to nosologic and/or diagnostic issues in dissociative identity disorder. We sought to investigate and compare the symptom patterns of these two clinical entities. We conducted a cross-sectional study involving 1314 participants who were screened with the Dissociative Experience Scale (DES) and the Somatoform Dissociation Questionnaire (SDQ). Of the participants, 272 who scored above the cut-off points for the screening questionnaires (DES score>30 and/or SDQ score>40 points) were invited to complete a structured interview using the Dissociative Disorders Interview Schedule (DDIS); of this subsample, only 190 participants agreed to participate in the second phase of the study. The mean score for the DES was 18.55±17.23, and the mean score for the SDQ was 30.19±13.32. Of the 190 participants, 167 patients were diagnosed as having a dissociative disorder (87.8%). We found that DD-NOS was the most prevalent category of dissociative disorder. There was a significantly larger percentage of patients in the DID group than in the DD-NOS group according to secondary features of DID and Schneiderian symptoms. The secondary features of DID and Schneiderian symptoms appeared to be more specific for DID, while no differences were detected between DID and DD-NOS based on most of the items on the SCL 90R. Further longitudinal studies are needed to determine the features that are similar and dissimilar between DD-NOS and DID.
Topics: Adult; Cross-Sectional Studies; Dissociative Disorders; Female; Humans; Male; Middle Aged; Outpatients; Prevalence; Surveys and Questionnaires
PubMed: 24461163
DOI: 10.1016/j.comppsych.2013.12.015 -
Minerva Pediatrica Aug 2004Dissociative disorder is well-known in adulthood but in many cases it begins in childhood where it is usually not taken into consideration, rarely diagnosed, and often...
Dissociative disorder is well-known in adulthood but in many cases it begins in childhood where it is usually not taken into consideration, rarely diagnosed, and often mistaken with borderline disorders. In childhood dissociation is well-defined: in a dimensional way by the presence of the dissociation symptoms over 2 SD and in a categorial view by the presence of primary symptoms. We made a psychiatric assessment on a child aged 11 years and 7 months, who said he heard "voices in his head". The assessment included: Children Dissociative Checklist (CDC), Adolescent Dissociative Experience Scale (A-DES), Children Depression Inventory (CDI), Wechsler Intelligence Scales for Children-Revised (WISC-R), Strength and Difficulties Questionnaire (SDQ), Children Behaviour Check-list (CBCL), (Scale Disturbi Attenzione Genitori, parent attention deficit scale, SDAG), Parent Conners Questionnaire, free conversation, a drawing, a neurological examination, an EEG-Holter and a semistructured psychiatric interview: K-SADS PL 1.0. SDQ, CDI and CBCL showed pathological scores in every area. K-SADS PL 1.0 excluded schizophrenia and showed: attention deficit, disthymic disorder, generalized anxiety disorder, oppositive-defiant disorder and conduct disorder with rage episodes, like borderline disorder. I.Q. was 76, SDAG (total 46) and Conners (mean points 1.81) showed a high score, simulating Attention Deficit with Hyperactivity disorder (ADHD). The presence of primary symptoms, like dissociative amnesia and very high scores in CDC (23, mean score for MPD) and in A-DES (85, mean 4.2) are useful for diagnoses. Dissociative disorder also exists in childhood, but it should be differentiated from ADHD and borderline disorder.
Topics: Child; Dissociative Disorders; Humans; Male; Wechsler Scales
PubMed: 15457142
DOI: No ID Found