Chapter -7 DISSOCIATIVE DISORDER

Definition  In psychiatry, dissociation is defined as an unconscious defense mechanism involving the segregation of any group of mental or behavioral processes from the rest persons psychic activity.  Dissociative disorder involve this mechanism so that there is a disruption in one or more mental functions, such as memory, identity, perception consciousness or motor behavior

Classification  Dissociative amnesia  Depersonalization/ derealization disorder  Dissociative fugue  Dissociative identity disorder

Amnesia Diagnosis Inability to recall impotent personal information, usually of a traumatic or stressful nature; may be localized, selective or generalized Epidemiology 6% prevalence ; increased in survivors of trauma. Treatment Psychotherapy, hypnosis

Fugue Diagnosis sudden, unexpected travel away from home or workplace with in ability to recall some or all of one’s past; may assume new identity. Epidemiology 0.2% prevalence. May occur under traumatic circumstances. Treatment Usually spontaneous recovery. Psychotherapy, hypnosis.

Identity disorder Diagnosis Two or more distinct personalities that take control of an individuals behavior; amnesia regarding personal history. Epidemiology 1.3% prevalence. M:F = 1.3:9. May have history of physical or sexual abuse. Treatment Three stages: symptoms stabilization, attention to trauma, reintegration. Psychotherapy, hypnosis. Symptoms oriented adjuvants.(anti depressive, anxiolytics)

Depersonalization disorder Diagnosis Persistence or recurrent experience or feeling detached from one’s mental processes or body. Epidemiology Rare disorder. Approximately 50% adults have experienced a single brief episode of depersonalization, precipitation by extreme stress. Treatment Psychotherapy. Drugs – clonazepam, fluoxetine, clomipramine.

The End