dissociative disorders basic headings
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DISSOCIATIVE DISORDERS
-DR. DEEPIKA SINGH-JR1, DEPT OF PSYCHIATRY,-GSMC & KEMH
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Dissociation:
“Disruption in the integrated functions of consciousnessmemory identityperception of the environment”
(DSM-IV)
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HISTORY
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EPIDEMIOLOGY:
Dissociative & conversion disorder constitutes 7.3 to 13% of all psychiatric cases.
Conversion > dissociation
Women > men
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CLASSIFICATION
DSM IV TR includes: Dissociative amnesia Dissociative fugue Dissociative identity disorder Depersonalization disorder Dissociative disorder NOS
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ICD 10 Classification includes:
1. DISSOCIATIVE AMNESIA
2. DISSOCIATIVE FUGUE
3. DISSOCIATIVE STUPOR
4. DISSOCIATIVE TRANCE & POSSESSION
5. DISSOCIATIVE D/Os OF MOVEMENT & SENSATION
6. OTHER DISSOCIATIVE D/Os
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Conversion disorder
In ICD 10 it is further classified as:
1) Dissociative motor disorder
2) Dissociative anesthesia & sensory loss
3) Dissociative convulsions
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SSSS
DISSOCIATIVE DISORDER
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Dissociative Amnesia DSM IV
1 or more episodes of inability to recall
important personal information (traumatic or stressful, that is too extensive to be explained by ordinary forgetfulness)
Disturbance does not occur during any other dissociative d/o & not due to direct effects of a substance or GMC
Symptoms cause clinically significant distress or impaired social or occupational ,etc functioning
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Types of amnesia:
Localized amnesiaSelective/ Systematized amnesiaGeneralized amnesiaContinuous amnesia
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Dissociative fugue
Amnesia plus flightLatin fugere, “to flee”
Sudden, unexpected travel with inability to recall one’s pastAssume new identity
May involve new name, job, personality characteristics
More often of brief durationRemits spontaneously
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Dissociative Fugue DSM IV
Sudden unexpected travel away from home or ones customary place of work, with inability to recall one’s past.
Confusion about personal identity or assumes new identity (partial or complete)
Not due to another dd d/o or direct effects of substances or GMC
Causes significant distress or impairment in imp areas of functioning
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Dissociative identity disorder
DSM-IV-TR criteriaPresence of two or more
personalities (alters)At least two of the alters
recurrently take control of behavior
Inability of at least one of the alters to recall important personal information
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Epidemiology
No identified reports of DID or dissociative amnesia before 1800 (Pope et al., 2006).
Major increases in rates since 1970s DSM-III (1980)
Diagnostic criteria more explicit Appearance of DID in popular culture
Sybil, 1973 Book and movie received much
attention
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Trance & possesion d/o
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Dissociative stupor
It is characterised by an absence or marked dimunition of voluntary movements & speech in the presence of normal or relatively preserved conscious awareness.
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Depersonalization
A. Persistent or recurrent experiences of feeling detached from & as if one is an outside observer of, one’s mental processes or body (e.g. like feeling like one is in a dream)
B. During the episode, reality testing remains intact
C. Causes significant distress or impairment in social, occupational functioning
D. Not due to another mental d/o, ,dissociative d/o, substances or GMC (temp lobe epilepsy)
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Dissociaive d/o nos
Dissociative symptoms are predominant, but the clinical picture does not meet full criteria for a dissociative d/o
1. Ganser’s syndrome; Prisoners with personality d/os giving approximate answers to questions-eg. 2+2=5 or talking past the point usually with other symptoms like amnesia, perceptual disturbances .
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Dissociative d/o nos
Mass hysteria Combat hysteria Dissociative trance d/o-in certain
cultures
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References
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References
1. CTP 2. SYNOPSIS OF
PSYCHIATRY 3. NEERAJ AHUJA PG
TEXTBOOK OF PSYCHIATRY
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THANKYOU…