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.

Dissociative Disorders NOS

This category includes disorders in
which the predominant feature is a
dissociative symptoms but does not
meet the criteria of any specific
dissociative disorder.
Ex: Gansers syndrome, brain
washing, cultural bound
syndromes..

prevalence
Dissociative amnesia 6%.
Depersonalization 19%. F:M = 4:1.
Dissociative identity disorder F:M=
5:1.

THAN
K
YOU