Dissociative Disorders

Dissociative Disorders and Suicidality in Psychiatric Outpatients

Administrator — Thu, 25 Jun 2009 05:00:00 +0000

Although it is common for patients with dissociative disorders to report a history of suicide attempts, there is very little data systematically comparing suicidality in patients with dissociative disorders versus patients without these disorders. The subjects in our study were 231 patients consecutively admitted to an inner-city, hospital-based outpatient psychiatric clinic. Eighty-two of these patients completed structured interviews for dissociative disorders, borderline personality disorder, and trauma history (dissociative disorders interview schedule) and for posttraumatic stress disorder and substance abuse (Structured Clinical Interview for DSM-IV). Patients receiving a dissociative disorder diagnosis were compared with nondissociative patients on measures of self-harm and suicidality.

Presence of a dissociative disorder was strongly associated with all measures of self-harm and suicidality. When we focused on patients with a history of multiple suicide attempts, significant associations were found between several diagnoses (dissociative disorder; borderline personality disorder; posttraumatic stress disorder; alcohol...

Childhood Emotional Abuse, Dissociation, and Suicidality Among Patients with Drug Dependency in ...

Administrator — Fri, 22 May 2009 13:08:26 +0000

By Tamar-Gurol D.; Sar V.; Karadag F.; Evren C.; Karagoz M.

Aim: The aim of the present study was to determine the prevalence and correlates of dissociative disorders among patients with drug dependency.

Methods: The Dissociative Experiences Scale (DES) was used to screen 104 consecutive patients at an addiction treatment center. Thirty-seven patients who had scores =30 were compared with 21 patients who scored <10 on the DES. Both groups were then evaluated using the Dissociative Disorders Interview Schedule and the Structured Clinical Interview for Dissociative Disorders (SCID-D). The interviewers were blind to the DES scores.

Results: Twenty-seven patients (26.0%) had a dissociative disorder according to the SCID-D. Dissociative patients were younger than the non-dissociative group. History of suicide attempt and/or childhood emotional abuse was significant predictors of a dissociative disorder. The majority (59.3%) of dissociative...

Amygdala and Hippocampal Volumes and Cognition

Administrator — Fri, 22 May 2009 13:07:18 +0000

Adult Survivors of Childhood Abuse with Dissociative Disorders

By Weniger G.; Lange C.; Sachsse U.; Irle E.

Objective: Trauma-exposed individuals with post-traumatic stress disorder (PTSD) display reduced amygdala and hippocampal size and impaired cognition. However, studies on trauma-exposed individuals with dissociative amnesia (DA) or dissociative identity disorder (DID) are lacking. Method: Twenty-three young women who had experienced severe childhood sexual/physical abuse, diagnosed with DA/DID or PTSD, and 25 healthy control subjects were subjected to 3D structural magnetic resonance imaging of amygdala and hippocampus and a clinical and neuropsychological investigation.

Results: Compared with controls, trauma-exposed subjects with PTSD (n = 10) displayed significantly reduced amygdala and hippocampal size and significantly impaired cognition. By contrast, trauma-exposed subjects with DA or DID (n = 13) displayed normal amygdala and hippocampal size and normal cognition.
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Amygdala and hippocampal volumes and cognition in adult survivors of childhood abuse with ...

Administrator — Fri, 22 May 2009 13:06:05 +0000

By Weniger G., Lange C., Sachsse U., Irle E.

Objective: Trauma-exposed individuals with post-traumatic stress disorder (PTSD) display reduced amygdala and hippocampal size and impaired cognition. However, studies on trauma-exposed individuals with dissociative amnesia (DA) or dissociative identity disorder (DID) are lacking.

Method: Twenty-three young women who had experienced severe childhood sexual/physical abuse, diagnosed with DA/DID or PTSD, and 25 healthy control subjects were subjected to 3D structural magnetic resonance imaging of amygdala and hippocampus and a clinical and neuropsychological investigation.

Results: Compared with controls, trauma-exposed subjects with PTSD (n = 10) displayed significantly reduced amygdala and hippocampal size and significantly impaired cognition. By contrast, trauma-exposed subjects with DA or DID (n = 13) displayed normal amygdala and hippocampal size and normal cognition.

Conclusion: We report for the first time volumetric results in subjects with...

Dissociative Identity Disorder and Schizophrenia:

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Schizophrenia and dissodative identity disorder (DID) are typically thought of as unrelated syndromes - a genetically based psychotic disorder versus a trauma-based dissociative disorder - and are categorized as such by the DSM-IV However, substantial data exit to document the elevated occurrence of psychotic symptoms in DID; awareness of these features is necessary to prevent diagnostic confusion. Recent research has also pointed out that schizophrenia and DID ovelap not only in psychotic symptoms but also in terms of traumatic antecedents, leading to a number of suggestions for revision of our clinical, theoretical, and nosologic understanding of the relationship between these two disorders. Copyright © 2008 by Current Medicine Group LLC.

Oligodipsia and Dissociative Experiences in Borderline Personality Disorder

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Objective: To test the frequency of attenuated fluid intake behavior (oligodipsia) in patients with borderline personality disorder (BPD) and to test if there is an inverse correlation between oligodipsia and the intensity of current dissociative experience in a pilot study. Method: Analyses were based on a sample of 15 BPD patients and 15 healthy controls. Fluid intake per diem and intensity of dissociative experience were measured by standardized self-reports daily for 7 days. Results: The BPD patients ingested a significantly lower fluid volume per diem when compared with healthy controls (P < 0.001). We found a strong correlation between intensity of co-occurring dissociative experience and fluid intake or urine osmolality (r = 0.762 and 0.665), independently of sleep quality and general BPD symptom severity.

Conclusion: The results indicate that oligodipsia may constitute a serious problem at least for a subgroup of BPD patients, and may be...

Dissociative Symptoms Are Positively Related to Stress in Borderline Personality Disorder

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Objective: According to DSM-IV criteria, dissociative symptoms in borderline personality disorder (BPD) occur in response to stress. Empirical evidence is, however, lacking. Method: Using ambulatory monitoring, we assessed dissociative symptoms and subjective ratings of stress every 60 min for 48 h on a palmtop computer in BPD-patients (n = 51), clinical controls (CC; major depression n = 25; panic disorder n = 26), and healthy controls (HC; n = 40). Data analyses were primarily based on hierarchical linear models. Results: In all groups, states of increased stress were paralleled by increased scores of dissociation, thus confirming the hypothesized association between stress and dissociation. The increase in dissociation was more pronounced in BPD-patients when compared with CC and HC. Additionally, BPD-patients reported heightened dissociative experience compared with CC and HC, even after controlling for stress.

Conclusion: Our data suggest that BPD-patients might be prone to dissociation when...

Amygdala and hippocampal volumes and cognition in adult survivors of childhood abuse with ...

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Objective: Trauma-exposed individuals with post-traumatic stress disorder (PTSD) display reduced amygdala and hippocampal size and impaired cognition. However, studies on trauma-exposed individuals with dissociative amnesia (DA) or dissociative identity disorder (DID) are lacking.

Method: Twenty-three young women who had experienced severe childhood sexual/physical abuse, diagnosed with DA/DID or PTSD, and 25 healthy control subjects were subjected to 3D structural magnetic resonance imaging of amygdala and hippocampus and a clinical and neuropsychological investigation.

Results: Compared with controls, trauma-exposed subjects with PTSD (n = 10) displayed significantly reduced amygdala and hippocampal size and significantly impaired cognition. By contrast, trauma-exposed subjects with DA or DID (n = 13) displayed normal amygdala and hippocampal size and normal cognition.

Conclusion: We report for the first time volumetric results in subjects with DA/DID without PTSD as comorbid diagnosis. Our results indicate preserved amygdala and...

Dissociative Disorder in Childhood Often Persists Into Adulthood

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Last Updated: 2008-08-14 10:52:05 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Dissociative disorder that begins in childhood or adolescence often persists into adulthood and is often followed by other psychiatric disorders, according to a report published online July 23rd in Child and Adolescent Psychiatry and Mental Health.

Dr. Thomas Jan from the University of Wuerzburg, Germany and colleagues analyzed the long-term clinical outcomes of 27 former patients with juvenile dissociative disorder (two of whom had committed suicide). The average age at onset in their patients was 11.7 years.

According to the researchers, 89% of these patients had "recovered or had markedly reduced symptoms" after treatment during childhood. However, at follow-up an average of 12.4 years after the initial diagnosis, 83% of the patients "met the criteria for some form of psychiatric disorder."

More than a quarter of...

Long-Term Outcome and Prognosis of Dissociative Disorder with Onset in Childhood or Adolescence

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Background: In the majority of cases short-term treatment outcome of juvenile dissociative disorder is rather favourable. In contrast, the long-term course seems to be less positive, but meaningful results are still fragmentary. The aim of this follow-up study is to bridge this gap to some extent describing the long-term outcome of juvenile dissociative disorder in a clinical sample. To our knowledge there is no comparable other long-term follow-up study which is based on a case definition according to actual classification systems using standardized interviews for individual assessment of the patients at the time of follow-up.

Methods: The total study group was made up of all patients treated for dissociative disorder at our department for child and adolescent psychiatry between 1983 and 1992 (N = 62). Two of these former patients committed suicide during the follow-up period (3%). We got information on the clinical course of 27...

Dissociative Experiences Differentiate Bipolar-II from Unipolar Depressed Patients

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Background: Dissociative symptoms are often seen in patients with mood disorders, but there is little information on possible association with subgroups and temperamental features of these disorders.

Methods: The Dissociative Experience Scale was administered to 85 patients with a DSM-IV Major Depressive Disorder (MDD) or Bipolar-II Disorder (BP-II). Both broad-spectrum dissociation (DES total score) and clearly pathological forms of dissociation (DES-Taxon) were assessed. Temperament was assessed using Akiskal and Mallya`s criteria of Affective Temperaments and the Jenkins Activity Survey (JAS) for Type A Behaviour.

Results: Sixty-five patients gave valid answers to DES. The mean DES and DES-T scores were higher in BP-II (16.8 and 12.7 respectively) compared to MDD (9.0 and 5.7); DES odds ratio (OR) = 1.58 (95% CI 1.15-2.18) and DES-T OR = 1.60 (95% CI 1.14-2.25) using univariate logistic regression analyses. There was no significant difference in DES score...