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PubMed1998

Serum levels of thyroid hormones as biological markers in a Swedish forensic psychiatric population.

BACKGROUND: In a Swedish study, delinquent boys had high serum levels of triiodothyronine (T3). Furthermore, former delinquents, followed up after about 30 years, had T3 levels significantly related to repeated criminality. The aim of the present study was to shed further light on the relationship between the thyroid hormones and specific behaviors and personality characteristics. METHODS: Serum levels of T3 and free thyroxine (FT4) were measured in 61 nonpsychotic male subjects at forensic psychiatric examinations and 66 normal controls. Psychopathy was determined by means of the Psychopathy Checklist-Revised (PCL-R) and DSM-III-R, DSM-IV, and ICD-10 diagnoses. RESULTS: The study population had high T3 and low FT4 values. Elevated T3 levels were related to type II alcoholism, Cluster B personality disorders, psychopathy as measured by the PCL-R, criminality, a diagnosis of a DSM-IV antisocial disorder, and an ICD-10 dissocial disorder. Serum levels of FT4 were negatively related to the same disorders and personality traits. CONCLUSIONS: The results indicate an intimate relationship between T3 and FT4, and abuse and antisocial behavior. They emphasize the importance of further studies on T3 as a biological marker for abuse, social deviance, and repeated violent behavior.

Adolescent↗
PubMedDate not supplied

A review of the EEG literature on Ganser's syndrome.

Ganser's syndrome has been classified as a histrionic disorder, a psychotic illness, a dissociative disorder, a factitious disorder, and an organic illness. The possibility of an underlying organic component to Ganser's syndrome is often implicated. A case which includes CT scan and EEG tests is presented and the EEG data in patients with Ganser's syndrome are reviewed. The majority of EEG data was not suggestive of any specific organic illness.

Adult↗
PubMed1994

Child dissociation and the family context.

Forty boys and their parents completed measures of dissociation, state anxiety, and perceptions of parental behaviors. Mothers completed a behavior problems checklist about their sons. The results indicated a correspondence between fathers' and sons' dissociation scores. In addition, links were found between parental dissociation, parental inconsistency and rejection, and child dissociation. The findings are discussed in the context of several recently proposed models of the etiology of child dissociative disorders.

Anxiety↗
PubMed2002

[Psychogenic paralysis in childhood and adolescence].

OBJECTIVES: This article presents the characteristics of psychogenic paralysis in children and adolescents. The overview covers the changes in its diagnostic classification from ICD-6 to ICD-10. METHODS: Characteristics of this diagnostic entity are presented and epidemiological data discussed on the basis of clinical studies from the literature. Among the dissociative disorders in children and adolescents, psychogenic paralysis shows a characteristic distribution according to sex and age. Furthermore the literature indicates a better prognosis for patients with this symptomatology than for children and adolescents with pseudoseizures and psychogenic vision disorders. RESULTS: Iatrogenic invasive diagnostic and therapeutic procedures, somatic injuries, infections and a model for the symptoms play an important role in the pathogenesis of gait disorders.

Adolescent↗
PubMed1998

[Questionnaire on dissociative symptoms. German adaptation, reliability and validity of the American Dissociative Experience Scale (DES)].

The "Fragebogen zu dissoziativen Symptomen (FDS)" represents the authorised German translation and adaptation of the "Dissociative Experience Scale" (DES; Bernstein and Putnam 1986). The original scale comprises 28 items covering dissociative experiences with regard to memory, identity, awareness and cognition according to DSM-III-R and DSM-IV. For the German version, 16 items were added to cover dissociative phenomena according to ICD-10, mainly pseudoneurological conversion symptoms. Reliability and validity of the German version were studied in a total sample of 813 persons and were compared to the results of the original version. Test-retest reliability of the FDS was rtt = 0.88 and Cronbach's consistency coefficient was alpha = 0.93, which is comparable to the results of the DES. The instrument differentiates between different samples (healthy control subjects, students, unselected neurological and psychiatric inpatients, neurological and psychiatric patients with a dissociative disorder and schizophrenics). The FDS is an easily applicable, reliable and valid measure to quantify dissociative experiences.

Dissociative Disorders↗
PubMed1989

Differentiating multiple personality disorder and complex partial seizures.

A number of reports have suggested that some cases of multiple personality disorder might be due to temporal lobe epileptic discharges. We have administered a structured interview, the Dissociative Disorders Interview Schedule, to 20 subjects with multiple personality disorder, 20 with complex partial seizures, and 28 neurologic controls. Subjects also completed the Dissociative Experiences Scale. Results show that multiple personality can be differentiated from complex partial seizures on a large number of items. The seizure patients did not differ from controls. The data indicate that the phenomenologies of these two disorders are distinct, and, therefore, there is little reason to assume a common etiology.

Adult↗
PubMed2003

Examination of the pathological dissociation taxon in depersonalization disorder.

In recent years, the pathologic dissociation taxon developed by Waller, Putnam, and Carlson (Psychological Methods 1:300-321, 1996) from a Dissociative Identity Disorder (DID) sample has been increasingly used in studies of dissociation in general. However, the taxon's convergence with dissociative diagnoses other than DID, as well as the taxon's central premise that pathologic dissociation is a categorical rather than a dimensional construct, remain areas of exploration. This report examines the applicability of the pathologic dissociation taxon to Depersonalization Disorder (DPD). The Dissociative Experiences Scale was administered to 100 consecutively recruited DPD subjects diagnosed by semistructured clinical interview and by the SCID-D. Taxon membership probability was calculated using the recommended SAS scoring program. Approximately 2/3 of subjects (N = 64) had a very high probability (>.80) of belonging to the taxon, while 1/3 of subjects had a very low probability (<.10) of belonging to the taxon. A taxon cutoff score of 13 yielded an 81% sensitivity in detecting the presence of DPD. The modest convergence between taxonic membership and clinical dissociative disorder diagnosis suggests that the taxon may have important limitations in its use, at least when applied to DPD in its current form. As previously, we continue to recommend a low taxon cutoff score (13) for the sensitive detection of depersonalization disorder. The inference that pathologic dissociation is a unitary and categorical entity is also discussed.

Adult↗
PubMed2000

A note on suicidal deterioration with recovered memory treatment.

BACKGROUND: Many patients who have been told they have Multiple Personality/Dissociative Identity Disorder (MPD/DID) seem to have deteriorated clinically after being so diagnosed. We report here the results of a survey of suicide attempts in patients diagnosed as having MPD and a comparison group hospitalized with a mood disorder. METHODS: Twenty individuals who had been diagnosed as having MPD, had developed false memories, and had relinquished them, were surveyed with respect to suicide attempts before and after the diagnosis. Twelve of those approached agreed to provide data and were compared with 12 patients from an in-patient mood disorders unit, matched for age and sex. RESULTS: In the MPD group more patients attempted suicide after being diagnosed than before and they made more separate attempts at suicide than before. The reverse was true in the comparison group with patients and suicide attempts before and after hospitalization. Comparing the numbers of attempts in the groups before diagnosis/hospitalization and afterward Chi(2)=20.177, DF=1, P<0.001. LIMITATIONS AND CONCLUSIONS: Both samples were highly selected, and the comparison group does not provide an exact control. Nevertheless, the results support a trend in the literature that finds the diagnosis of multiple personality disorder and the use of recovered memory treatment are harmful.

Adult↗
PubMed1975

Multiple personality. A single case study with a 15 year follow-up.

A review of the literature relating to multiple personality is presented together with a study of a single case of hysterical aetiology that demonstrates the development of multiple personality from a fugue amnesic state. A re-examination of this case after 15 years without significant psychotherapeutic intervention demonstrates a tendency towards remission. The view that multiple personality is a form of fugue, not necessarily hysterical, in which an alternative personality is adopted and that this behaviour is reinforced by the attention that it receives, is discussed.

Adolescent↗
PubMed1990

Twelve cognitive errors about multiple personality disorder.

Multiple personality disorder (MPD) is often responded to with extreme skepticism by mental health professionals. This skepticism is based in part on twelve cognitive errors about the disorder that can be corrected by argument and research evidence. The errors include the mistaken ideas that MPD patients have more than one personality; that the diagnosis means such patients are not responsible for their actions; that MPD patients are really just borderlines; that MPD is an iatrogenic artifact; that MPD can be created experimentally; that MPD must be rare; that MPD is a therapeutic metaphor; that everyone has different personalities; that MPD will go away if you ignore it; that patients pretend to have MPD in order to please the therapist; that the abuse histories of MPD patients are confabulated; and that one must be a hypnotist to treat MPD. It is important to correct these cognitive errors because MPD is not rare. It can be diagnosed with good reliability and its features are stable and consistent in a number of large published series. Although definitive treatment-outcome studies have not been conducted, clinical experience to date suggests that the disorder can often be cured with psychotherapy. After successful integration, MPD patients function much better than before, and can be released from the mental health system.

Borderline Personality Disorder↗
PubMed1976

Observations on the evolution of the hysterical symptomatology.

A retrospective study of the records of 17,571 psychiatric patients who attended the out-patients department of Eginition Hospital in Athens during three two-year periods (1948-50, 1958-60 and 1969-71) revealed a statistically significant decrease in the frequency of patients diagnosed as suffering from hysteria, a statistically significant decrease in the relative frequency of patients with hysterical fits and with mental conversion symptoms, and a statistically significant increase in the relative frequency of patients with mixed conversion symptoms. The findings confirm the notion that hysteria is still a 'woman's disease', although a statistically significant increase in male participation was noted. The significance of the above findings for the understanding of certain aspects of hysteria is discussed.

Adult↗
PubMed1991

Rational psychopharmacology in the treatment of multiple personality disorder.

The current state of the data concerned with psychopharmacologic interventions for multiple personality disorder (MPD) is reviewed. Common sense guidelines are provided for drug treatment of MPD. An overview is given for use of medications for specific symptoms commonly found in MPD patients, such as affective, posttraumatic stress disorder, and sleep disorder symptoms.

Combined Modality Therapy↗
PubMed2005

Nonconvulsive status epilepticus precipitated by carbamazepine presenting as dissociative and affective disorders in adolescents.

Nonconvulsive status epilepticus can be confused with psychiatric disorders. Inappropriate drug treatment can represent a precipitating factor. We describe two patients with idiopathic generalized epilepsy in whom nonconvulsive status epilepticus, aggravated by carbamazepine, was misdiagnosed as psychiatric disorder. A 14-year-old girl experienced a tonic-clonic seizure at age 12 years preceded by monthly episodes of confusion with awkward behavior since age 9 years. She was treated with carbamazepine, and the episodes of confusion became more frequent, leading to a diagnosis of dissociative disorder. An electroencephalogram during one of these episodes revealed nonconvulsive status epilepticus. Substitution of carbamazepine with valproic acid controlled the episodes of status epilepticus. A 23-year-old woman presented at age 16 years with a tonic-clonic seizure. Since early adolescence, she had had episodes of depressive mood, worsening of school performances, and facial tics. Carbamazepine treatment caused worsening of the depressive episodes and facial tics. An electroencephalogram during a typical episode revealed nonconvulsive status epilepticus. Carbamazepine substitution with valproate led to seizure freedom and behavioral improvement. Nonconvulsive status epilepticus should be suspected and searched for in patients with epileptic seizures and ictal or fluctuating behavioral disorders.

Adolescent↗
PubMedDate not supplied

[Dispute over the multiple personality disorder: theoretical or practical dilemma?].

Dissociative identity disorder (DID) could also be referred to as multiple personality disorder (MPD). Due to rare occurrence and difficulty in its' identification it is infrequently diagnosed in Poland. The indicated disorder has been portrayed by the authors throughout the historical context, referring to initial 18th century's references concerning dissociation. A typical dissociatively disordered person has been characterized along with his individual personality categories such as: original personality, altered personality, host and personality fragment. Moreover various diagnosis criterions of DID have been introduced. DID has also been differentiated with other disorders: PTSD (post-traumatic stress disorder) and BPD (borderline personality disorder). A hypothesis has been set up, stating that DID is directly correlated with the trauma experienced during childhood, while PTSD is linked with traumatic lived-through events in the later period of ones' life. The most contemporary and frequently used research tools for DID have been indicated: dissociative experience scale (DES) and somatoform dissociation questionnaire (SDQ-20). Based upon the known literature, the authors have presented treatment methods such as hypnotherapy and recorded therapy sessions. It is the view of the authors that the switching in dissociative identity disorder is of adaptive character (it occurrs depending upon adaptive needs).

Borderline Personality Disorder↗
PubMedDate not supplied

Gender differences in dissociation. A dimensional approach.

Considering that epidemiological research on dissociative disorders has suggested a 9 to 1 predominance of female cases, this study investigated the relationship between gender and dissociation using a dimensional approach. A total of 2,153 participants from different diagnostic groups completed the Dissociative Experience Scale. In order to control for the confounding effect of current psychopathology a subgroup 790 subjects additionally completed the SCL-90. We did not find any differences in the general or pathological dissociation scores. Hypothetical gender differences in dissociative psychopathology were not a function of diagnostic categories. There were no significant sex differences in the distribution of high dissociators. Our findings suggest that men and women do not generally differ in dissociative psychopathology. The implications for future investigations on the epidemiology, etiology, and psychobiology of dissociative symptoms are discussed.

Adolescent↗