Dissociative Symptoms in Schizophrenic Patients with Positive and Negative Symptoms

Abstract

Given the close historical relationship between schizophrenia and dissociative disorders, namely multiple personality disorder, we assessed 27 ICD-10 diagnosed schizophrenic inpatients for dissociative symptoms using the German version of the Dissociative Experience Scale and compared them to a nonclinical control group matched for gender and age. Other self-report instruments covering general psychopathology, and an expert rating on the predominance of positive or negative schizophrenic symptoms, were also administered. Schizophrenic patients have significantly more dissociative symptoms than controls. Moreover, patients with a plus type of schizophrenia show significantly higher levels of dissociation than patients mainly exhibiting less productive symptoms. However, dissociative phenomena are only significantly correlated with delusions and hallucinatory behavior, and do not show any correlation with other positive symptoms of schizophrenia. Severe dissociative psychopathology is also associated with impairment in other psychopathological dimensions. The implications of these findings are discussed with regard to the theory of dissociation, the differential diagnosis between schizophrenia and dissociative disorders and a possible contribution of dissociative phenomenology to the clinical heterogeneity of schizophrenia.

Dissociation, Epileptiform Discharges and Chaos in the Brain: Toward a Neuroscientific Theory of Dissociation

“…A primary emphasis on positive symptoms may result in false-positive diagnoses of schizophrenia and false-negative diagnoses of dissociative identity disorder (Elason & Ross, 1995). On the other hand there are findings that show markedly high level of dissociation in schizophrenic patients (Bernstein & Putnam 1986;Read et al, 2001;Spitzer, Haug, & Freyberger, 1997;Startup 1999). The above data suggest close relationship between schizophrenia and dissociative disorders.…”

Prevalance of Childhood Trauma and Dissociative Experiences Among Adult Offenders

“…37 Burada ayırıcı olarak dikkat edilmesi gereken, dissosiyatif kimlik bozukluğuna sahip kimselerin kişilik olarak belli alanlarda beklenmedik güçlere sahip olmasıdır. BuDerya DENİZ Turkiye Klinikleri J Foren Sci Leg Med 2017;14(2): [34][35][36][37][38][39][40][41][42][43][44][45][46][47] nunla beraber, Borderline kişilik bozukluğuna sahip kimseler dışa dönük ve siyah-beyaz düşünce tarzına sahip iken, dissosiyatif kimlik bozukluğu olan hastaların içe dönük ve kendi iç dünyaları ile alakadar olmalarıdır. 37 Dissosiyatif amnezi de adli süreçte dikkati çeken klinik tablolardan biridir.…”

“…Álvarez ve ark.nın, şizofreni hastaları üzerinde yaptıkları çalışmada, bu kişilerin kontrol gruplarına oranla daha yüksek çocukluk çağı travmaları ve dissosiyatif yaşantılar puanlarına sahip olduğu saptanmış-tır. 40 Yapılan araştırmada, şiddet içeren suç olayı Derya DENİZ Turkiye Klinikleri J Foren Sci Leg Med 2017;14(2): [34][35][36][37][38][39][40][41][42][43][44][45][46][47] sırasında hezeyan varlığı görülen vakalarda DES'e göre pozitif olma riski, hezeyan görülmeyenlere göre 5,65 kat yüksek olarak bulunması da bu gö-rüşü destekleyen diğer bir araştırma bulgusudur.…”

Trauma, Dissociation and Synthetic Metacognition in Schizophrenia

“…Ross (2009) proposed a separated dissociative type of schizophrenia characterized by a history of severe chronic childhood trauma, prominent dissociative symptoms and a lack of cognitive disorganization or thought disorder. Dissociation is in general linked to positive symptoms of schizophrenia (Spitzer et al, 1997), but dissociative amnesia is related to negative symptoms (Vogel et al, 2009a). In respect to a type of trauma, dissociation has been found related to emotional and physical abuse (Schafer et al, 2012), physical abuse and neglect (Sar et al, 2010), and childhood neglect (Vogel et al, 2009b).…”