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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 -
Nature Communications Dec 2020Ketamine produces immediate antidepressant effects and has inspired research into next-generation treatments. Ketamine also has short term dissociative effects, in which... (Review)
Review
Ketamine produces immediate antidepressant effects and has inspired research into next-generation treatments. Ketamine also has short term dissociative effects, in which individuals report altered consciousness and perceptions of themselves and their environment. However, whether ketamine's dissociative side effects are necessary for its antidepressant effects remains unclear. This perspective examines the relationship between dissociative effects and acute and longer-lasting antidepressant response to ketamine and other N-methyl-D-aspartate (NMDA) receptor antagonists. Presently, the literature does not support the conclusion that dissociation is necessary for antidepressant response to ketamine. However, further work is needed to explore the relationship between dissociation and antidepressant response at the molecular, biomarker, and psychological levels.
Topics: Animals; Antidepressive Agents; Dissociative Disorders; Humans; Ketamine; Receptors, N-Methyl-D-Aspartate
PubMed: 33353946
DOI: 10.1038/s41467-020-20190-4 -
Tijdschrift Voor Psychiatrie 2021Conversion and dissociation in their relationship have made a lot of pendulum movements over time between moving together and away from each other. In the run-up to the... (Review)
Review
BACKGROUND
Conversion and dissociation in their relationship have made a lot of pendulum movements over time between moving together and away from each other. In the run-up to the introduction of DSM-5, it was argued that conversion should be classified as a dissociative disorder, but this didn't happen.
AIM
In this article, the clinical scientific evidence is examined for the relationship between conversion and dissociation. We provide an overview of the recent clinical studies that examine both syndromes together. We also investigate the main overlapping predisposing characteristics and psychopathological explanatory models of both syndromes.
METHOD
Literature review in PubMed and PsycArticles.
RESULTS
Our findings confirm that there is a large comorbidity between conversive and dissociative symptoms in clinical reality. Both syndromes have a high prevalence of reported trauma and emotion dysregulation. However, evidence for present biomarkers is still llimited. The underlying explanation models are applicable for both conversion and dissociation.
CONCLUSION
We want to draw attention to the plea to bring conversion disorders back together with dissociative disorders. Moreover, the possible presence of trauma, the influential role of psychosocial stressors, the present psychiatric co-morbidity and the style of emotion regulation seem to justify the approach to conversion problems from a biopsychosocial perspective rather than from a purely biomedical perspective.
Topics: Comorbidity; Conversion Disorder; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Emotions; Humans
PubMed: 34231865
DOI: No ID Found -
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 -
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 -
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 -
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 -
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 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 -
European Journal of Psychotraumatology 2022Most individuals with dissociative disorders (DDs) report engaging in self-injury.
BACKGROUND
Most individuals with dissociative disorders (DDs) report engaging in self-injury.
OBJECTIVE
The present study aimed to understand the reasons for self-injury among a clinical sample of 156 DD patients enrolled in the TOP DD Network study.
METHOD
Participants answered questions about self-injury, including a prompt asking how often they are aware of the reasons they have urges to self-injure, as well as a prompt asking them to list three reasons they self-injure.
RESULTS
Six themes of reasons for self-injury, each with subthemes, were identified in the qualitative data: (1) Trauma-related Cues, (2) Emotion Dysregulation, (3) Stressors, (4) Psychiatric and Physical Health Symptoms, (5) Dissociative Experiences, and (6) Ineffective Coping Attempts. Participants reported that they were able to identify their reasons for self-injuring sometimes (60.26%) or almost always (28.85%), with only 3.20% unable to identify any reasons for their self-injury.
CONCLUSION
Results suggest that the vast majority of DD patients (92.31%) reported being at least partially unaware of what leads them to have self-injury urges, and many individuals with DDs experience some reasons for self-injury that are different from those with other disorders. The treatment implications of these findings are discussed.
Topics: Adult; Cues; Dissociative Disorders; Female; Health Status; Humans; Male; Self-Injurious Behavior; Stress, Psychological; Surveys and Questionnaires; Wounds and Injuries
PubMed: 35126883
DOI: 10.1080/20008198.2022.2026738