What are Dissociative Disorders?
Dissociative disorders refer to the interruption or collapse of a person's memory, consciousness, identity, or perception under pathological and involuntary conditions. Generally, the word "dissociation" means being disconnected from others, the surroundings, the feeling, or your own, as if one is outside one's body. Actually, dissociative disorders are psychiatric conditions caused by mental factors acting on susceptible individuals, which also is a defense mechanism to protect patients themselves from past psychological trauma. Common symptoms of dissociative disorders vary according to the type of dissociative disorders, but mainly include transient or persistent loss of memory (amnesia), blurred sense of identity, distorted and unreal perception of surroundings, and so forth.
The incidence rate of dissociative disorders is relatively lower compared with other psychiatric disorders, about 2% in the United States among all ages. Women are more likely affected by dissociative disorders than men. The causes of dissociative disorders are not well understood but are mainly related to experienced trauma, including physical trauma, mental trauma, long-term stress, accidents, abuse, etc. And the severity of adult dissociation disorder may be directly related to the severity of trauma in childhood. The latest American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has listed 3 types of dissociative disorders: dissociative identity disorder, depersonalization-derealization disorder, and dissociative amnesia.
Diagnosis and Treatment of Dissociative Disorders
The prevalence of dissociative disorders is much higher in psychiatric patients than that in the general population. But the diagnosis of dissociative mental disorder is difficult to distinguish from some other psychiatric disorders, like bipolar disorder, borderline personality, and schizophrenia. DSM-5 has pointed that dissociative disorders are characterized and diagnosed by the disruption of or discontinuity in memory, identity, cognition, emotion, and behavior, and the dissociative manifestations might affect every area of psychological functioning. Questionnaires, structured clinical interviews, physical or psychiatric exam, and additional information can also be used to assist in accurate diagnosis.
The treatment of dissociative disorders depends on the specific type of disease. But the pathophysiology of dissociation disorders is still not well understood, the current treatment of dissociative disorders typically are psychotherapy and medication, of which psychotherapy is the primary treatment. Psychotherapy, also known as counseling or psychosocial therapy, aims to control the dissociative process and symptoms and improve the life quality by the means of hypnosis, dialectical behavioral therapy, and cognitive behavioral therapy. There are currently no specific drugs to treat dissociative disorders. Antipsychotic drugs, such as antidepressants, antianxiety drugs, sedatives, can be used to control and alleviate psychiatric symptoms associated with dissociative disorders.
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