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PubMed2001

Pain-determined dissociation episodes.

OBJECTIVES: Dissociation disorders are a group of conditions characterized by a disruption of integrated function of consciousness, memory, or perception. The purpose of this report is to describe the impact of increased pain levels on the genesis of two types of dissociation disorders, dissociative fugue ( DF) and dissociative identity disorder ( DID), in patients with chronic pain ( PWCP). DESIGN/PATIENTS/INTERVENTIONS/OUTCOME MEASURES: From November 1992 to July 2000, 2 DID and 4 DF patients were identified from 2,544 consecutive PWCP evaluated and/or treated at the University of Miami Comprehensive Pain and Rehabilitation Center. The salient features of these six dissociation PWCP are presented. All four DF PWCP completed a dissociation experience scale first at the time of identification of the dissociation disorder (with chronic pain) and one alleging their experiences with dissociation predevelopment of chronic pain. RESULTS: Frequency percentage for dissociation for this population was 0.235%. For all four of the DF PWCP, dissociation episodes began after the onset of chronic pain. All six (100%) PWCP described or associated their episodes of dissociation to times when their pain would increase. Mean dissociation scale scores for the four DF PWCP were 1.4 +/- 1.11 pre-chronic pain and 20.53 +/- 16.82 at time of identification of the dissociative disorder (with chronic pain). CONCLUSIONS: The frequency percentage for dissociation within PWCP is small compared with psychiatric populations. There may be an etiological association between the development of dissociation episodes and the development of chronic pain and/or increases in chronic pain.

Journal Article↗
PubMed2006

Prevalence of dissociative disorders in psychiatric outpatients.

OBJECTIVE: The purpose of the study was to assess the prevalence of DSM-IV dissociative disorders in an inner-city outpatient psychiatric population. METHOD: Subjects were 231 consecutive admissions (84 men and 147 women, mean age=37 years) to an inner-city, hospital-based outpatient psychiatric clinic. The subjects completed self-report measures of dissociation (Dissociative Experiences Scale) and trauma history (Traumatic Experiences Questionnaire). Eighty-two patients (35%) completed a structured interview for dissociative disorders (Dissociative Disorders Interview Schedule). RESULTS: The 82 patients who were interviewed did not differ significantly on any demographic measure or on the self-report measures of trauma and dissociation from the 149 patients who were not interviewed. Twenty-four (29%) of the 82 interviewed patients received a diagnosis of a dissociative disorder. Dissociative identity disorder was diagnosed in five (6%) patients. Compared to the patients without a dissociative disorder diagnosis, patients with a dissociative disorder were significantly more likely to report childhood physical abuse (71% versus 27%) and childhood sexual abuse (74% versus 29%), but the two groups did not differ significantly on any demographic measure, including gender. Chart review revealed that only four (5%) patients in whom a dissociative disorder was identified during the study had previously received a dissociative disorder diagnosis. CONCLUSIONS: Dissociative disorders were highly prevalent in this clinical population and typically had not been previously diagnosed clinically. The high prevalence of dissociative disorders found in this study may be related to methodological factors (all patients were offered an interview rather than only those who had scored high on a screening self-report measure) and epidemiological factors (extremely high prevalence rates for childhood physical and sexual abuse were present in the overall study population).

Adult↗
PubMed1995

Hypnotizability and dissociativity in sexually abused girls.

Research on the relation between hypnotizability and clinical dissociation has led to contradictory findings. Measures of hypnotizability and dissociation are only weakly correlated in general population samples, but studies of posttraumatic stress and dissociative disorders patients have found elevated levels of clinical dissociation and hypnotizability respectively. This study assesses the relationships among hypnotizability, clinical dissociation and traumatic antecedents in 54 sexually abused girls, ages 6-15 years, and 51 matched controls. Hypnotizability was assessed on initial evaluation and again in matched subsamples at one year using the Stanford Hypnotic Clinical Scale for Children. Clinical dissociation was assessed using the Child Dissociative Checklist. Abuse variables were extracted from Child Protective Services reports. There were no significant differences in hypnotizability between abuse and control subjects. There were significant differences in clinical dissociation initially and on 1-year retest. Hypnotizability and clinical dissociation were only weakly correlated (r(105) = .118, p = NS). However, in the abuse group, highly hypnotizable subjects were significantly more dissociative. Higher levels of clinical dissociation were associated with abuse by multiple perpetrators and co-presence of physical abuse independent of the sexual abuse. A small subgroup of "double dissociative" subjects, high in both hypnotizability and dissociativity, was identified. Double dissociation was associated with multiple perpetrators and earlier onset of sexual abuse.

Adolescent↗
PubMed2005

Peritraumatic and persistent dissociation in the presumed etiology of PTSD.

OBJECTIVE: Dissociative responses that occur at the time of a trauma (peritraumatic dissociation) have been described as a major risk factor for subsequent posttraumatic stress disorder (PTSD). The current study evaluated peritraumatic dissociation and PTSD from a multivariate perspective, along with a less-investigated phenomenon: trauma-specific dissociation that begins during or after an event and continues until the time of assessment (persistent dissociation). METHOD: In two studies, 52 local community participants and 386 participants from the general population with histories of exposure to at least one traumatic event were assessed for the presence of PTSD and were administered measures of dissociation and peritraumatic distress. RESULTS: In both studies, peritraumatic dissociation, persistent dissociation, peritraumatic distress, and generalized dissociative symptoms were associated with PTSD by univariate analyses. However, multivariate analyses in both studies indicated that PTSD status was no longer related to peritraumatic dissociation once other variables (especially persistent and generalized dissociation) were taken into account. In contrast, persistent dissociation was a strong predictor at univariate and multivariate levels. CONCLUSIONS: Trauma-related persistent dissociation is a substantial predictor of PTSD, whereas peritraumatic dissociation ceases to predict PTSD at the multivariate level. These findings suggest that it is less what happens at the time of a trauma (e.g., disrupted encoding) that predicts PTSD than what occurs thereafter (i.e., persistent avoidance).

Adult↗
PubMed2005

Dissociative disorders among inpatients with drug or alcohol dependency.

OBJECTIVE: To determine the prevalence of dissociative disorders among inpatients with alcohol or drug dependency. METHOD: The Dissociative Experiences Scale was used to screen 215 consecutive inpatients admitted to the dependency treatment center of a large mental hospital over a 1-year period (March 1, 2003, to March 31, 2004). Patients who had scores of 30.0 or above were compared with patients who scored below 10.0 on the scale. The patients in both groups were then evaluated using the Dissociative Disorders Interview Schedule and the Structured Clinical Interview for DSM-IV Dissociative Disorders. The interviewers were blind to the Dissociative Experiences Scale scores. RESULTS: Of the patients, 36.7% had a Dissociative Experiences Scale score of 30.0 or above. The prevalence of DSM-IV dissociative disorders was 17.2% (N = 37). On average, 64.9% of these patients' dissociative experiences had started 3.6 years (SD = 2.9; range, 1.0-11.0 years) before onset of the substance use. Patients with dissociative disorders were younger, and the mean duration of their remission periods was shorter. Dissociative disorder patients tended to use more than 1 substance, and drugs were used more frequently than alcohol in this group. The frequency of borderline personality disorder, somatization disorder, history of suicide attempt, and childhood abuse and neglect occurred more frequently in the dissociative disorder group than in the nondissociative disorder group. History of suicide attempt (p = .005), female sex (p = .050), and childhood emotional abuse (p = .010) were significant predictors of a dissociative disorder diagnosis. Significantly more patients with dissociative disorders stopped their treatment prematurely (p < .001). CONCLUSION: Impact of dissociative disorders on development and treatment of substance dependency requires further study.

Adult↗
PubMed1998

Dissociated vertical deviation and head tilts.

INTRODUCTION: The association of anomalous head posture and dissociated vertical deviation does not seem to be appreciated, as evidenced by the paucity of literature linking these two conditions. METHOD: The series describes 14 patients who had an anomalous head posture and dissociated vertical deviation. The assumed head tilts appeared to decrease the magnitude and improve the motor control of dissociated vertical deviation. RESULTS: Twelve of 14 patients tilted their heads contralateral to the eye with the dissociated vertical deviation, or away from the eye with a larger amount of dissociated vertical deviation if the disorder was bilateral. Two patients tilted their heads to the same side as the eye with the dissociated vertical deviation. Forced head tilt-testing in the opposite direction showed an increase in the magnitude of the dissociated vertical deviation or poorer control of the deviation. Dissociated vertical deviation was not related to oblique muscle dysfunction. Peripheral fusion was demonstrated in 10 patients, as evidenced by low-grade stereopsis or Worth 4 dot fusion at near. One patient did not show any demonstrable fusion with conventional tests. Another did not show evidence of stereopsis, but Worth 4 dot testing was not performed. Two other patients were too young to cooperate with sensory testing. Anomalous head posture was controlled or minimized after the control of the dissociated vertical deviation by surgery in four patients. Two patients showed improved stereopsis after surgery for dissociated vertical deviation. CONCLUSION: Dissociated vertical deviation should be included in the differential diagnosis of an ocular cause of head tilts. Forced contralateral head tilttesting will confirm whether dissociated vertical deviation is the cause if motor control of the dissociated vertical deviation worsens or becomes manifest rather than latent. The presence of an anomalous head posture in patients with dissociated vertical deviation can be improved with strabismus surgery.

Adult↗
PubMedDate not supplied

[Effect of major nutrient elements on the growth and population homogeneity of the R, S and M dissociants of Pseudomonas aeruginosa and the glucose oxidation and fermentation pathways].

The population homogeneity of the stationary-phase monocultures of Pseudomonas aeruginosa dissociants was studied as a function of the initial content of major nutrient elements (C, N, and P) in the cultivation medium. The monocultures of the dissociants remained homogeneous during cultivation if the initial concentrations of the major nutrient elements were either sufficiently high or, conversely, very low, but became heterogeneous during cultivation in unbalanced (with respect to the major nutrient elements) media. At the initial concentration of nitrate in the medium equal to 0.07% or phosphate equal to 0.004-0.014%, the initially homogeneous population of R dissociant cultivated to the stationary growth phase turned out to contain 30-40% of S-type cells, whereas the initially homogeneous population of S dissociant was found to contain 50-80% of M-type cells. The population of M dissociant remained homogeneous throughout the cultivation period. R dissociant grew better at sufficiently high concentrations of glucose, nitrate, and phosphate in the medium, whereas M dissociant grew better when the initial concentrations of these nutrients were low. During the cultivation of R dissociant, the pH of the medium changed insignificantly, and the C/P ratio (the ratio of the carbon and phosphorus consumed during growth) was minimal (among the three dissociants), indicating that the R dissociant accomplishes the oxidative pathway of glucose metabolism. During the cultivation of the M dissociant, the pH of the medium dropped to 3.4-3.9, and the C/P ratio was maximal, indicating that this dissociant accomplishes the fermentative pathway of glucose metabolism. During the cultivation of the S dissociant, the pH of the medium and the C/P ratio exhibited variations, indicating that this dissociant triggers its pathways of glucose metabolism.

Carbon↗
PubMed2005

Neurophysiological correlates of increased verbal working memory in high-dissociative participants: a functional MRI study.

BACKGROUND: Dissociation, defined as a disruption in usually integrated mental functions, is found not only in DSM-IV dissociative disorders, but also in post-traumatic stress disorder and eating disorders. Dissociative phenomena are also common in the general population, and may reflect a constitutionally determined cognitive style rather than a pathological trait acquired through experiencing adverse life events. In pathological dissociation, evidence has been presented for episodic memory dysfunction. In contrast, in high-dissociative subjects increased performance has been found for episodic memory and dual task performance. These findings have been linked to changes in working memory capacity. METHOD: In the present study, the authors sought to extend these findings by using functional magnetic resonance imaging during performance of two parametric working memory tasks. We tested 21 healthy low- and high-dissociative participants. RESULTS: High-dissociative participants performed slightly better during both tasks. Imaging data showed that both groups activated similar networks for both tasks, i.e. (bilateral) dorsolateral (DL) and ventrolateral prefrontal cortex (PFC), parietal cortex, and supplementary motor area. Group x task interactions were found in the high-dissociative group in L DLPFC and L parietal cortex; in the low-dissociative group in R fusiform gyrus. The differences in the high-dissociative group were independent from performance differences, implying that high-dissociative subjects generally recruit this network to a greater extent. CONCLUSIONS: These results confirm earlier findings using a verbal WM task in high-dissociative participants, and are compatible with the conceptualization of non-pathological dissociation as an information-processing style, characterized by distinct attentional and mnemonic abilities.

Adult↗
PubMed2005

Dissociation in children and adolescents as reaction to trauma--an overview of conceptual issues and neurobiological factors.

The discovery of trauma as an aetiological factor in mental dissociation is more than a century old, but neurobiological research in the last decade has started to clarify a neurobiological basis that may shed light on the complex symptomatology observed in traumatized children. Dysfunctional stress responses, emotional-based style of functioning, hyperarousal, anxiety, irritability, impulsivity, disengaged attention and educational underachievement may thus begin to be better understood. The aim of this overview is to give an update on the concept of dissociation and the links to new neurobiological findings, hopefully to reduce unawareness, wrong diagnostics or even neglect of dissociative symptomatology by clinicians in child and adolescent psychiatry in the Nordic countries. A systematic overview of studies of mental dissociation in children and adolescents published over the last decade disclosed a total of 1019 references; 309 papers regarding the concept of dissociation, memory, trauma and the neurobiological correlates were studied in detail. The assumption of a trauma-genic basis of dissociation is still most discussed in the literature. The importance of other childhood trauma in addition to sexual abuse is outlined, focusing on childhood interpersonal trauma. Recent research on traumatized children and adolescents has demonstrated some permanent neurochemical as well as functional and structural abnormalities in brain areas that are involved in the integrative process of cognition and memory. This research begins to clarify the cerebral basis and mechanisms for the trauma-related dissociation observed in dissociative (conversion) disorders, post-traumatic stress disorder (PTSD) and somatoform disorders. New perspectives on the nature of subcortical processes linking the phenomena of dissociation and traumatic experiences may have important implications for the understanding of dissociative disorders in children and adolescents. They may be regarded as complex environmentally induced developmental, supporting the view that PTSD and somatization disorders may be specific forms of dissociative processes to be categorized together with dissociative (conversion) disorders as "trauma-related dissociative disorders".

Adolescent↗
PubMed1996

The development and psychometric characteristics of the Somatoform Dissociation Questionnaire (SDQ-20).

According to 19th century French psychiatry and contemporary clinical observations, dissociation pertains to both psychological and somatoform components of experience, reactions, and functions. Because such an instrument was lacking, we aimed to develop a self-reporting questionnaire measuring what we propose to call somatoform dissociation. Patients with dissociate disorder and with other DSM-IV psychiatric diagnoses completed a list of 75 items that, according to clinical experience and expert judgment, could reflect instances of somatoform dissociation. Separate logistic analyses and determination of discriminant indices per item revealed 20 items that best discriminated between those with and without dissociative disorders. Mokken analysis showed that these items are strongly scalable on a dimensional latent scale interpreted to measure somatoform dissociation. Reliability of the scale was high. Construct validity was supported by high intercorrelations with the Dissociation Questionnaire, which measures psychological dissociation, and higher scores of patients with dissociative identity disorder compared with patients with dissociative disorders not otherwise specified. In conclusion, the Somatoform Dissociation Questionnaire (SDQ-20) is a scale of good psychometric quality, which measures somatoform dissociation. The symptoms pertain to negative and positive dissociative phenomena, which were well known in 19th century French psychiatry as the mental stigmata and mental accidents of hysteria.

Adolescent↗
PubMedDate not supplied

The relationship between dissociative proneness and alexithymia.

BACKGROUND: Dissociative reactions and alexithymia are two strategies that have been put forward as coping mechanisms to alleviate painful emotions. It is the clinical impression that dissociation is related to certain alexithymia features. In line with the coping hypothesis, it was predicted that the relationship between dissociative tendencies and alexithymia would be partly mediated by current levels of stress and/or by past traumatic experiences. Furthermore, dissociation may also be related to enhanced fantasizing, although alexithymia has traditionally been associated with an incapacity to fantasize. METHODS: Data were obtained from 833 nonclinical participants on dissociative tendencies, alexithymia, childhood abuse, current stress and socially desirable behavior. Correlation analyses followed by multiple regression were performed. RESULTS: Dissociative tendencies appeared to be especially related to one alexithymic feature: a difficulty in identifying feelings. This relationship was partially mediated by levels of current stress. A history of trauma did not predict dissociation measures. Furthermore, highly dissociative participants were more fantasy prone than low-dissociative participants. CONCLUSIONS: The results of this study support the idea that in a nonclinical group dissociation may provide a way to cope with current stressful events, and that this is associated with a difficulty in identifying feelings. It is argued that two types of dissociation may exist, one trait-like type of dissociation that is associated with fantasy proneness and other related factors, and a trauma-related type of dissociation that is more apparent within the clinical range.

Adaptation, Psychological↗
PubMed2006

Tracking scientific interest in the dissociative disorders: a study of scientific publication output 1984-2003.

OBJECTIVE: We attempted to track scientific interest in dissociative amnesia and dissociative identity disorder by estimating the annual output of publications regarding these entities over the last 20 years. METHODS: Using a standard medical index, PsycINFO, we counted the number of indexed publications involving dissociative amnesia and dissociative identity disorder listed for each year. We then compared these rates with those of well-established diagnoses such as anorexia nervosa, alcohol abuse, and schizophrenia. We also systematically reviewed all publications involving dissociative amnesia that appeared in 2003. RESULTS: Annual publications involving dissociative amnesia and dissociative identity disorder rose from low levels in the 1980's to a sharp peak in the mid 1990's, followed by an equally sharp decline to only about one quarter of their peak levels by 2002 and 2003. In contrast, all of the 25 comparison diagnoses in our survey showed constant or steadily rising publication rates; none showed the 'bubble' pattern of the dissociative disorders. Of the 34 papers involving dissociative amnesia identified by PsycINFO for 2003, 10 (32%) appeared skeptical of the validity of dissociative amnesia and/or recovered-memory therapy. Despite a detailed search using multiple medical indices and search terms, we could find only 13 explicit cases of individuals with dissociative amnesia worldwide in the 2003 literature. CONCLUSIONS: Dissociative amnesia and dissociative identity disorder have not generated consistent scientific interest over the years, but instead apparently enjoyed a brief period of fashion that now has waned. Overall, our observations suggest that these diagnostic entities presently do not command widespread scientific acceptance.

Amnesia↗
PubMed1987

Monensin inhibits ligand dissociation only transiently and partially and distinguishes two galactosyl receptor pathways in isolated rat hepatocytes.

Monensin has been shown to inhibit the dissociation of internalized asialoorosomucoid (ASOR) from galactosyl (Gal) receptors in hepatocytes (Harford et al., J. Cell. Biol., 96:1824, 1983). Examination of the long-term kinetics of dissociation of a single round of surface-bound 125I-ASOR in the presence of monensin revealed, however, that dissociation resumed after a lag of 30-40 min. Dissociation proceeded slowly with apparent first order kinetics (k = 0.006-0.022 min-1) and reached a plateau after 4 h, both in freshly isolated cells in suspension and in cells cultured for 24 h. Only a portion of the ligand bound to surface Gal receptors was capable of dissociating. The degree of dissociation was correlated with the expression of a subpopulation of receptors we have recently designated as state 1 Gal receptors (Weigel et al., Biochem. Biophys. Res. Commun. 140:43, 1986). The recovery and dissociation of a portion of 125I-ASOR-receptor complexes after the lag period is not due to a depletion of monensin, since a second addition of the drug has no affect once dissociation resumes. Furthermore, as assessed by the accumulation of the fluorescent dye acridine orange, cells have not recovered the ability to acidify intracellular compartments during the time that dissociation occurs. The results support a model for the hepatic Gal receptor system, in which there are two functionally different receptor populations, recycling pathways, and ligand processing pathways. Monensin blocks dissociation of 125I-ASOR from receptors in the major pathway completely. In the minor pathway dissociation proceeds to completion only after a lag. In this minor pathway monensin appears to temporarily delay a maturation or translocation process that must occur prior to dissociation. We conclude that the observed dissociation in the presence of monensin cannot be mediated by low pH, or by pH or pNa gradients.

Animals↗
PubMed1999

Dissociation in the laboratory: a comparison of strategies.

Several methods for inducing dissociation in the laboratory were examined in a sample of 78 undergraduate students. Participants scoring high or low on the Dissociative Experiences Scale participated in three dissociation challenge conditions: (a) dot-staring task, (b) administration of pulsed photic and audio stimulation and (c) stimulus deprivation. Participants recorded their dissociative experiences both before and after each of the three challenge conditions. Across conditions, high DES participants reported significantly more dissociative sensations than low DES participants, even after controlling for pre-challenge dissociation. Moreover, regardless of DES status, pulsed photo and audio stimulation produced the greatest level of dissociative symptoms. The findings suggest that the induction of dissociative symptoms in a nonclinical sample is easily accomplished in the laboratory and that those who report more dissociative symptoms in their day-to-day life exhibit more pronounced dissociative symptoms when undergoing dissociative challenge in the laboratory. Implications for the study and treatment of dissociative symptoms are discussed.

Acoustic Stimulation↗
PubMed2000

Dissociation in people who have near-death experiences: out of their bodies or out of their minds?

BACKGROUND: Some people who come close to death report having experiences in which they transcend the boundaries of the ego and the confines of time and space. Such near-death experiences (NDEs) share some features with the phenomenon of dissociation, in which a person's self identity becomes detached from bodily sensation. This study explored the frequency of dissociative symptoms in people who had come close to death. METHODS: 96 individuals who had had self-reported NDEs, and 38 individuals who had come close to death but who had not had NDEs completed a mailed questionnaire that included a measure of "depth" of near-death experience (the NDE scale) and a measure of dissociative symptoms (the Dissociative Experiences Scale). Median scores in the two groups were compared with Mann-Whitney U tests. The association between depth of NDE and dissociative symptoms was tested by Spearman's rank-order correlation between scores on the NDE scale and the dissociative experiences scale. FINDINGS: People who reported NDEs also reported significantly more dissociative symptoms than did the comparison group. Among those who reported NDEs, the depth of the experience was positively correlated with dissociative symptoms, although the level of symptoms was substantially lower than that of patients with pathological dissociative disorders. INTERPRETATION: The pattern of dissociative symptoms reported by people who have had NDEs is consistent with a non-pathological dissociative response to stress, and not with a psychiatric disorder. A greater understanding of the mechanism of dissociation may shed further light on near-death and other mystical or transcendental experiences.

Consciousness Disorders↗
PubMed1999

Somatoform dissociation discriminates among diagnostic categories over and above general psychopathology.

OBJECTIVE: The primary aim of this study was to investigate the hypothesis that somatoform dissociation would differentiate among specific diagnostic categories after controlling for general psychopathology. METHOD: The Somatoform Dissociation Questionnaire (SDQ-20), the Dissociative Experiences Scale, and the Symptom Checklist-90-R were completed by patients with DSM-IV diagnoses of dissociative disorders (n = 44), somatoform disorders (n = 47), eating disorders (n = 50), bipolar mood disorder (n = 23), and a group of consecutive psychiatric outpatients with other psychiatric disorders (n = 45), mainly including anxiety disorders, depression, and adjustment disorder. RESULTS: The SDQ-20 significantly differentiated among diagnostic groups in the hypothesised order of increasing somatoform dissociation, both before and after statistically controlling for general psychopathology. Somatoform dissociation was extreme in dissociative identity disorder, high in dissociative disorder, not otherwise specified, and increased in somatoform disorders, as well as in a subgroup of patients with eating disorders. In contrast with somatoform dissociation, psychological dissociation did not discriminate between bipolar mood disorder and somatoform disorders. CONCLUSIONS: Somatoform dissociation is a unique construct that discriminates among diagnostic categories. It is highly characteristic of dissociative disorder patients, a core feature in many patients with somatoform disorders, and an important symptom cluster in a subgroup of patients with eating disorders.

Adult↗
PubMed1998

Psychometric characteristics of the somatoform dissociation questionnaire: a replication study.

BACKGROUND: The present study aimed to replicate the results of previous studies concerning the development of two versions of the Somatoform Dissociation Questionnaire. The SDQ-20 evaluates the severity of somatoform dissociative phenomena, and the SDQ-5 is a dissociative disorders screening instrument. METHODS: Thirty-one patients with dissociative disorders and 45 consecutive psychiatric outpatients with other DSM-IV diagnoses completed the SDQ-20 and SDQ-5 as well as the Dissociation Questionnaire which measures psychological dissociation. RESULTS: Mokken scale analysis showed that the items of the SDQ-20 are strongly scalable on a latent unidimensional scale. Internal consistency was high. The SDQ-20 convergent validity was supported by high intercorrelations with the DIS-Q. Dissociative patients obtained significantly higher scores than comparison patients. Patients with dissociative identity disorder scored significantly higher compared to patients with dissociative disorder nos. Sensitivity (94%) and specificity (98%) of the SDQ-5 were very satisfactory, as were, at an estimated prevalence rate of dissociative disorders of 10% among psychiatric patients, positive predictive value (84%) and negative predictive value (99%). CONCLUSIONS: All results replicated the first findings, and therefore corroborate the conclusion that the SDQ-20 and SDQ-5 are instruments of sound psychometric quality, and that somatoform dissociative phenomena are core symptoms of complex dissociative disorders.

Adolescent↗
PubMed1998

Frequency of dissociative disorders among psychiatric inpatients in a Turkish University Clinic.

OBJECTIVE: The aim of this study was to determine the rate of dissociative disorders among psychiatric inpatients in a university clinic in Turkey. METHOD: The Dissociative Experiences Scale was used to screen 166 consecutive inpatients admitted to the psychiatry clinic of a university hospital. The patients who had scores higher than 30 were matched for age and gender with 19 of the patients who scored below 10 on the scale. The patients in both groups were then interviewed with the Dissociative Disorders Interview Schedule by interviewers who were blind to their diagnoses and scores on the Dissociative Experiences Scale. Patients who were diagnosed as having a dissociative disorder according to the Dissociative Disorders Interview Schedule were then interviewed by a clinician. RESULTS: Twenty-four (14.5%) of the 166 patients had a score higher than 30 on the Dissociative Experiences Scale; 17 patients (10.2%) were diagnosed as having a dissociative disorder according to the Dissociative Disorders Interview Schedule. Nine patients (5.4%) had clinically confirmed dissociative identity disorder. CONCLUSIONS: A considerable proportion of the psychiatric inpatients in a Turkish university psychiatry clinic had dissociative disorder. Clinicians who work in general psychiatric inpatient units should be alert for chronic complex dissociative disorders.

Adolescent↗