Dissociative Disorders

This document defines and describes the main types of dissociative disorders, including dissociative amnesia, dissociative fugue, trance and possession disorders, dissociative identity disorder, depersonalization/derealization disorder, and dissociative disorders not otherwise specified. It provides details on the symptoms and management approaches for each disorder type. Dissociative disorders are characterized by disruptions in consciousness, memory, identity and perception of the environment. Prevalence rates provided indicate that dissociative amnesia affects 6% of people, depersonalization affects 19%, and dissociative identity disorder is more common in females.

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Dissociative Disorders

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Hassan

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Dissociative Disorders

Dr: Yasir Abdalla

MBBS. MD Psychiatry

Definition
The essential feature of dissociative
disorders is a disruption in the
usually integrated functions of:
consciousness, memory, identity and
perception of the environment.

Dissociative Disorders
1.
2.
3.
4.
5.

Dissociative amnesia.
Dissociative fugue.
Trance and possession disorders.
Dissociative Identity Disorder.
Depersonalization / Derealization
disorder.
6. Dissociative disorders NOS.

Dissociative Amnesia- 1
Characterized by marked difficulties
with recall of important information,
usually due to traumatic or stressful
memory, that can not be explained
by normal forgetfulness.

Dissociative Amnesia- 1
Management
1. Supportive psychotherapy in the
initial stages.
2. CBT when the patient recovers from
amnesia.
3. Diazepam was used for abreaction:
recalling traumatic memory in semi
conscious state.

2- Dissociative Fugue
The individual undertakes
unexpected yet organized journey
away from home or from ordinary
places.
Self care is maintained.
There is amnesia (partial/complete).
It also include confusion about
identity and assumption of new
personality.
Now it is included in D. amnesia as

3- Trance and Possession

Disorders
1. Trance
. Loss of the usual sense of self
identity.
. Narrowing of awareness of
immediate surrounding and
selective focusing on environmental
stimuli.
. Limitation of movement, posture
and speech.

4- Trance and Possession

Disorders
2- Possession
The individual is convinced that
he/she has been taken over by a
spirit, power, deity,..

4- Dissociative Identity
Disorder
Presence of two or more distinct
personality states. The disruption in
identity causes:
1. Discontinuation in sense of self.
2. Discontinuation in sense of agency.
3. Changes in affect, behavior,
consciousness, memory, perception,
cognition and sensory motor
functioning.
4. Gaps in memory.

4- Dissociative Identity
Disorder
Management
1. Supportive psychotherapy in initial
stage.
2. CBT when patient is stable.
3. Antidepressants reduce depressive
symptoms and stabilize the mood.

-5
Depersonalization/Derealiza
tion

Persistent or recurrent experiences

of feeling detached from/ outside
observer of ones own mental
processes or body (like in a dream).
Reality testing is intact.
In Derealization the same feelings
occur toward ones surrounding.
Causes clinical significant distress &
impairment.

-5
Depersonalization/Derealiza
tion

Management
1. SSRI may be helpful in frequent
depersonalization disorder and co
morbid depressive symptoms.