Clandestine Psychopathology: Unrecognized Dissociative Disorders in Inpatient Psychiatry

Abstract

Surveys among Israeli mental health professionals found that almost half of them doubt the validity of dissociative disorders (DD) and have no experience in either diagnosing or treating DD patients. These findings, in line with arguments that DDs are socially construed North American phenomena, call for the need to investigate it in Israel. Eighty-one psychiatric inpatients were screened for dissociative pathology. Participants categorized as having low levels of dissociation (n = 26) and those demonstrating high levels of dissociation (n = 22) were asked to participate in a Structured Clinical Interview for the DSM-Dissociative Disorders-Revised. One-quarter of all participants were identified as having probable dissociative psychopathology. Based on the Structured Clinical Interview for the DSM-Dissociative Disorders-Revised, estimates of DD range between 12 and 21%. None of the participants had any indication of a DD diagnosis in their medical records. Diagnosis of personality disorder and psychiatric comorbidity were related to the likelihood of a DD diagnosis and its severity.

Childhood Traumatic Experiences, Dissociative Symptoms, and Dissociative Disorder Comorbidity Among Patients With Panic Disorder: A Preliminary Study

“…Alteration in memory and consciousness due to dissociation may affect the presentation symptoms of comorbid disorders. Patients with dissociative disorders have a relatively high number of comorbid diagnoses, which may prevent clinicians from recognizing the dissociative disorder in the overall picture (Ginzburg, Somer, Tamarkin, & Kramer, 2010).…”

Global functioning and disability in dissociative disorders

“…Despite their frequency of occurrence in psychiatric populations, the clinical relevance of DDs is unclear. In clinical practice, they are rarely diagnosed and rarely considered in treatment planning (Foote et al, 2006;Ginzburg et al, 2010). Some clinicians even question the diagnostic validity of certain types of DDs (Pope et al, 1999;Ginzburg et al, 2010).…”

“…In clinical practice, they are rarely diagnosed and rarely considered in treatment planning (Foote et al, 2006;Ginzburg et al, 2010). Some clinicians even question the diagnostic validity of certain types of DDs (Pope et al, 1999;Ginzburg et al, 2010). One approach to evaluating the clinical relevance of DDs is to determine their impact on daily functioning.…”

Epidemiology of Dissociative Disorders: An Overview

“…Patients with dissociative disorders have relatively high number of comorbid diagnoses which may prevent clinicians from recognizing the dissociative disorder in the overall picture [34]. A screening study on college students [9] documented a large overlap between dissociative disorders and borderline personality disorder.…”