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Psychiatria Polska Feb 2020Mental disorders occur in patients with epilepsy significantly more frequently than in the general population or in those with other chronic diseases. The specificity of... (Review)
Review
Mental disorders occur in patients with epilepsy significantly more frequently than in the general population or in those with other chronic diseases. The specificity of epilepsy as a condition of the central nervous system with complex somatic, psychic and social consequences contributes to co-occurrence of these disorders. Moreover, common patomechanisms are suggested for epilepsy and mental disorders, associated with disturbances of bioelectrical activity and neurotransmission in certain areas of the brain.The authors present a review of main groups of mental disorders observed in epileptic patients: psychotic, affective, anxiety, personality, and conduct disorders. They discuss their epidemiology and clinical presentation, with a particular focus on their risk factors and temporal relation to epileptic seizures. They also highlight problems associated with differential diagnosis and optimal therapeutic strategy. Mental disorders have a significant impact on the quality of life and functioning of patients with epilepsy. Further exploration of interrelationships between these illnesses, as well as cooperation between neurologists and psychiatrists promote an early and precise diagnosis of mental disturbances in this group of patients and their effective treatment.
Topics: Adult; Affective Symptoms; Antisocial Personality Disorder; Dissociative Disorders; Epilepsy; Female; Humans; Male; Mental Disorders; Prevalence; Quality of Life; Risk Factors; Somatoform Disorders
PubMed: 32447356
DOI: 10.12740/PP/93886 -
Neuroscience and Biobehavioral Reviews Aug 2022Elevated responsiveness to verbal suggestions is hypothesized to represent a predisposing factor for the dissociative disorders (DDs) and related conditions. However,... (Meta-Analysis)
Meta-Analysis Review
Elevated responsiveness to verbal suggestions is hypothesized to represent a predisposing factor for the dissociative disorders (DDs) and related conditions. However, the magnitude of this effect has not been estimated in these populations nor has the potential moderating influence of methodological limitations on effect size variability across studies. This study assessed whether patients with DDs, trauma- and stressor-related disorders (TSDs), and functional neurological disorder (FND) display elevated hypnotic suggestibility. A systematic literature search identified 20 datasets. A random-effects meta-analysis revealed that patients displayed greater hypnotic suggestibility than controls, Hedges's g = 0.92 [0.66, 1.18]. This effect was observed in all subgroups but was most pronounced in the DDs. Although there was some evidence for publication bias, a bias-corrected estimate of the group effect remained significant, g = 0.57 [0.30, 0.85]. Moderation analyses did not yield evidence for a link between effect sizes and methodological limitations. These results demonstrate that DDs and related conditions are characterized by elevated hypnotic suggestibility and have implications for the mechanisms, risk factors, and treatment of dissociative psychopathology.
Topics: Dissociative Disorders; Humans; Hypnosis; Hypnotics and Sedatives; Suggestion
PubMed: 35760389
DOI: 10.1016/j.neubiorev.2022.104751 -
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 -
European Neurology 2016This historical essay outlines early ideas and clinical accounts of hysteria. It reproduces verbatim parts of a remarkable text of Thomas Sydenham. This provides the...
This historical essay outlines early ideas and clinical accounts of hysteria. It reproduces verbatim parts of a remarkable text of Thomas Sydenham. This provides the most detailed description of hysterical symptoms, contemporary treatment and particularly Sydenham's opinions about the nature of the disorder. His portrayal is compared to later and modern concepts and classification.
Topics: Dissociative Disorders; England; History, 17th Century; Humans; Hysteria; Somatoform Disorders
PubMed: 27658273
DOI: 10.1159/000450605 -
Journal of Trauma & Dissociation : the... 2020The dissociative subtype of posttraumatic stress disorder (PTSD) is estimated to characterize about 12-30% of those with PTSD. Some research links this subtype with...
The dissociative subtype of posttraumatic stress disorder (PTSD) is estimated to characterize about 12-30% of those with PTSD. Some research links this subtype with increased severity of PTSD symptoms compared to samples with "classic" PTSD. However, prevalence and severity rates reported in the literature have varied. One possible explanation for these discrepancies could be related to where the populations were sampled. Therefore, we investigated whether these differences are still observed when holding level of care constant. We collected data from 104 women at a partial and residential psychiatric hospital program focused on trauma-related disorders. Participants completed self-report questionnaires assessing trauma exposure, symptoms and provisional diagnosis of PTSD, trauma-related thoughts and beliefs, and feelings of shame. All participants reported a history of childhood and/or adulthood trauma exposure. Eighty-eight (85%) met criteria for PTSD, and of those, seventy-three (83%) met criteria for the dissociative subtype as assessed by the Dissociative Subtype of PTSD Scale. A series of independent t-tests revealed no significant differences between the "classic" and dissociative PTSD groups with respect to lifetime or childhood trauma exposure, posttraumatic cognitions, shame, or overall PTSD severity. Our results suggest that samples with classic PTSD and the dissociative subtype may not differ in some types of symptom severity when holding level of care constant. Importantly, however, we found at partial/residential level of care the majority of patients with PTSD were dissociative. Given the elevated prevalence rate in this sample, these findings support the need to assess dissociative symptoms, particularly in more acute psychiatric settings.
Topics: Adolescent; Adult; Adult Survivors of Child Abuse; Dissociative Disorders; Female; Hospitals, Psychiatric; Humans; Middle Aged; Prevalence; Psychiatric Status Rating Scales; Psychotherapy; Risk Factors; Self Report; Shame; Stress Disorders, Post-Traumatic; Surveys and Questionnaires
PubMed: 31607239
DOI: 10.1080/15299732.2019.1678214 -
Current Psychiatry Reports Jan 2017Dissociation involves disruptions of usually integrated functions of consciousness, perception, memory, identity, and affect (e.g., depersonalization, derealization,... (Review)
Review
Dissociation involves disruptions of usually integrated functions of consciousness, perception, memory, identity, and affect (e.g., depersonalization, derealization, numbing, amnesia, and analgesia). While the precise neurobiological underpinnings of dissociation remain elusive, neuroimaging studies in disorders, characterized by high dissociation (e.g., depersonalization/derealization disorder (DDD), dissociative identity disorder (DID), dissociative subtype of posttraumatic stress disorder (D-PTSD)), have provided valuable insight into brain alterations possibly underlying dissociation. Neuroimaging studies in borderline personality disorder (BPD), investigating links between altered brain function/structure and dissociation, are still relatively rare. In this article, we provide an overview of neurobiological models of dissociation, primarily based on research in DDD, DID, and D-PTSD. Based on this background, we review recent neuroimaging studies on associations between dissociation and altered brain function and structure in BPD. These studies are discussed in the context of earlier findings regarding methodological differences and limitations and concerning possible implications for future research and the clinical setting.
Topics: Borderline Personality Disorder; Brain; Brain Mapping; Cerebral Cortex; Depersonalization; Dissociative Disorders; Humans; Limbic System; Neuroimaging; Stress Disorders, Post-Traumatic
PubMed: 28138924
DOI: 10.1007/s11920-017-0757-y -
Psychiatry and Clinical Neurosciences Dec 2016The cross-cultural validity of dissociative possession and trance disorders is a matter of some debate, limiting research and meaningful interpretation of prevalence... (Review)
Review
The cross-cultural validity of dissociative possession and trance disorders is a matter of some debate, limiting research and meaningful interpretation of prevalence data. Intimate to these concerns is the status of spirit possession categories studied in the social sciences, particularly anthropology. These two categories are phenomenologically related and display similar epidemiological associations. In India, dissociative and conversion disorders are fairly common in clinical settings. There is no doubt that there are true cultural variations in possession and trance disorders. A new framework may enable clinicians to better understand possession states and spirit possession.
Topics: Conversion Disorder; Dissociative Disorders; Humans; Spirit Possession
PubMed: 27485275
DOI: 10.1111/pcn.12425 -
The Israel Journal of Psychiatry and... 2015Post traumatic patients experience a wide range of symptoms, some of them existential in nature which we term "dissociative being." Many varied psychotherapeutic... (Review)
Review
Post traumatic patients experience a wide range of symptoms, some of them existential in nature which we term "dissociative being." Many varied psychotherapeutic approaches are available for the treatment of post traumatic patients. Nevertheless, in view of this disorder's complexity, therapists face shortcomings when employing each of these therapeutic interventions. In order to understand this, we posit the principle we call "dissociative reality" for the treatment of trauma survivors. Our proposed method "speaks the patient's own language," harnessing dissociative elements to help individuals recall, re-enact and integrate traumatic experiences, where words are insufficient, while still upholding reality. We believe that this may be seen as an effective part of the therapeutic dialogue, and suggest that therapists may consider supplementing this approach in their treatment "toolkit" for patients with post traumatic stress and other trauma related disorders, irrespective of their declared therapeutic approach.
Topics: Dissociative Disorders; Humans; Psychotherapy; Stress Disorders, Post-Traumatic
PubMed: 25841110
DOI: No ID Found -
European Journal of Psychotraumatology 2023The fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced the dissociative subtype of posttraumatic stress disorder (D-PTSD). To...
The fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced the dissociative subtype of posttraumatic stress disorder (D-PTSD). To assess this subtype, the Dissociative Subtype of PTSD Scale (DSPS), a 15-item self-report measure to identify lifetime and current dissociative symptoms of D-PTSD, was developed. However, so far, the scale has only been validated in war veterans. Moreover, criterion validity and diagnostic utility have not been examined yet. We aimed to validate the DSPS in two samples of civilian trauma-exposed German-speaking participants. In Study 1, a pre-registered online study, participants with and without PTSD symptoms ( = 558) answered questionnaires about traumatic experiences, dissociation, PTSD, depression, generalized anxiety disorder, somatic symptom disorder, alcohol use disorder, absorption, and dissociative responding to trauma-related questionnaires. In Study 2, which used secondary data of a pre-registered clinical study, participants with a PTSD diagnosis ( = 71) answered questionnaires about traumatic experiences, dissociation, PTSD, depression, generalized anxiety disorder, somatic symptom disorder, and dissociative responding to standardized trauma exposure. Moreover, PTSD, D-PTSD, and other diagnoses were assessed with structured clinical interviews. Analyses confirmed a three-factor structure as well as high internal consistency, and high convergent, discriminant, and criterion validity of the DSPS. Moreover, the scale was able to identify a latent D-PTSD group and individuals with D-PTSD diagnosis. The DSPS constitutes a reliable and valid tool to assess D-PTSD symptoms in clinical practice and research and thereby may contribute to a better understanding of these debilitating symptoms.
Topics: Humans; Stress Disorders, Post-Traumatic; Medically Unexplained Symptoms; Psychometrics; Dissociative Disorders; Anxiety Disorders
PubMed: 37593980
DOI: 10.1080/20008066.2023.2238492 -
Neurosciences (Riyadh, Saudi Arabia) Jul 2017To assess the relationships between the dissociative features of FMS and the pain, psychological status, and functional status.
OBJECTIVE
To assess the relationships between the dissociative features of FMS and the pain, psychological status, and functional status.
METHODS
Twenty-seven women with fibromyalgia syndrome (FMS) and 24 controls from the Istanbul Physical Medicine and Rehabilitation Hospital (2013-2015) were included in this cross-sectional study. The Diagnostic and Statistical Manual of Mental Disorders Structured Clinical Interview for Axis I Disorders was used to evaluate the participants. A visual analogous scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were used to assess the levels of pain, quality of sleep and functional and psychological statuses. The Dissociative Experiences Scale (DES) was used to evaluate the dissociative features.
RESULTS
The BDI, BAI and DES scores were statistically significantly higher in the cases of FMS. There were remarkable associations between all but 2 of the DES and FIQ scores, while positive correlations were found between the DES and, VAS pain and sleep quality scores. The prevalences of current and lifelong dysthymia, and major depressive disorder; not otherwise specified, common anxiety and somatoform disorders were higher in the cases of FMS.
CONCLUSION
Pain, physical function and emotional status appear to be associated with dissociative features in FMS. Further studies are required to define these relationships and improve treatment.
Topics: Adult; Case-Control Studies; Comorbidity; Cross-Sectional Studies; Dissociative Disorders; Female; Fibromyalgia; Humans; Mental Disorders; Middle Aged; Pain; Pain Measurement; Psychiatric Status Rating Scales; Sleep Initiation and Maintenance Disorders; Turkey; Young Adult
PubMed: 28678214
DOI: 10.17712/nsj.2017.3.20160538