The Role of Dissociative Compartmentalization in Difficult-to-Treat Psychotic Phenomena

Treise, Cate; Pérez, Jesús

doi:10.3389/fpsyg.2021.533884

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…8,10,11 Dissociative symptoms are seen in a variety of psychiatric disorders; 3,4,[12][13][14][15] symptoms can be chronic and severely disabling. 3,8 Dissociation has previously been partitioned into compartmentalisation and experiential detachment; 4,16 however, recent evidence from network analyses of dissociative experiences has extended this to include absorption (becoming absorbed in an external stimulus or one's own imagination to the point of reduced awareness of self and surroundings) and depersonalisation/derealisation. 17,18 In compartmentalisation, individuals lose the ability to govern processes or actions over which they would normally have control; it is theorised to underpin FND-seizures and dissociative amnesia, for example.…”

Section: Discussionmentioning

confidence: 99%

Dissociation and its biological and clinical associations in functional neurological disorder: systematic review and meta-analysis

et al. 2022

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Background Studies have reported elevated rates of dissociative symptoms and comorbid dissociative disorders in functional neurological disorder (FND); however, a comprehensive review is lacking. Aims To systematically review the severity of dissociative symptoms and prevalence of comorbid dissociative disorders in FND and summarise their biological and clinical associations. Method We searched Embase, PsycInfo and MEDLINE up to June 2021, combining terms for FND and dissociation. Studies were eligible if reporting dissociative symptom scores or rates of comorbid dissociative disorder in FND samples. Risk of bias was appraised using modified Newcastle–Ottawa criteria. The findings were synthesised qualitatively and dissociative symptom scores were included in a meta-analysis (PROSPERO CRD42020173263). Results Seventy-five studies were eligible (FND n = 3940; control n = 3073), most commonly prospective case–control studies (k = 54). Dissociative disorders were frequently comorbid in FND. Psychoform dissociation was elevated in FND compared with healthy (g = 0.90, 95% CI 0.66–1.14, I2 = 70%) and neurological controls (g = 0.56, 95% CI 0.19–0.92, I2 = 67%). Greater psychoform dissociation was observed in FND samples with seizure symptoms versus healthy controls (g = 0.94, 95% CI 0.65–1.22, I2 = 42%) and FND samples with motor symptoms (g = 0.40, 95% CI −0.18 to 1.00, I2 = 54%). Somatoform dissociation was elevated in FND versus healthy controls (g = 1.80, 95% CI 1.25–2.34, I2 = 75%). Dissociation in FND was associated with more severe functional symptoms, worse quality of life and brain alterations. Conclusions Our findings highlight the potential clinical utility of assessing patients with FND for dissociative symptomatology. However, fewer studies investigated FND samples with motor symptoms and heterogeneity between studies and risk of bias were high. Rigorous investigation of the prevalence, features and mechanistic relevance of dissociation in FND is needed.

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