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Introduction: Dissociative disorders are post-traumatic and psychotic syndromes that generally develop over time and during childhood. These disorders are gaining increasing acceptance due to the validity of the diagnosis among different populations, but despite empirical evidence supporting the validity of this diagnosis and its association with trauma, this disorder remains an uncertain and ambiguous diagnosis .On the other hand, due to the limited information available about the diagnosis and treatment of this disorder, this study aims to identify this disease, its dimensions, and its treatment processes. Methods: The present study was an interpretative study with a qualitative approach that attempted to identify influential variables in this field by adopting the meta-synthesis technique. The statistical population of this study was all printed sources in the field of dissociative disorder, and 30 articles were selected according to the Casp Rubric approach. Results: The analysis was conducted using an Open, Axial, and Selective Coding system, and ultimately the results indicate 5 important axes in the field of dissociative disorder, which are empirical etiology, treatment, dissociative experiences, and dissociative disorder. Conclusion: Dissociative disorder is characterized by three types of disorders. Individuals with type 1 have high functioning. Individuals with type 2 have lower functioning and experience a higher rate of comorbidity with other disorders. Individuals with type 3 are usually unable to work, have worse living conditions, and require frequent hospitalization. [ABSTRACT FROM AUTHOR]

Social media platforms have provided people with a psychiatric label the opportunity to build communities and share their stories without relying on the mediation of therapists, publishers, or broadcasters. Among them are people who identify not as one whole self, but as a system of plural personalities, often labeled as dissociative identity disorder (DID). People with plural identities started sharing videos on YouTube as a means to convey their experiences and fight stigma. In 2009, this gave rise to a distinct sub-genre of vlogs created by people with plural identities and DID: the ‘Meet the Alters’ video, where various personalities introduce themselves to the audience. This paper traces the fifteen-year evolution of these videos in order to show how the makers of the Meet the Alters videos use YouTube’s affordances and the conventions of the vlog genre to navigate a lack of hermeneutic resources outside of psychiatric discourse and understanding, allowing them to communicate their experiences in a relatable way to a general audience. Through a close reading of the staging and performance of plurality in thirteen Meet the Alters videos, posted between 2009 and April 2024, the paper reveals key developments and particularities of this genre. The analysis highlights how plural YouTubers create their own hermeneutic resources to present their potentially unfamiliar or unruly experiences in an understandable manner to their viewers. In conversation with emerging and growing plural communities, these hermeneutic resources have been continually supplemented and refined. After fifteen years, this has resulted in a rich identity-centered discourse that enables the performance and communication of plural experiences. We argue that YouTube’s specific affordances and the generic conventions of the vlog have been crucial in the emergence and development of non-stigmatising, non-psychiatric hermeneutic resources for expressing plural experiences.

Il s'agit d'étudier les enjeux psychopathologiques et socioculturels du TDI (Trouble Dissociatif de l'Identité), en lien avec la façon dont l'épidémie des « personnalités multiples » s'est dissoute à la fin du XXe siècle. Nous retraçons d'abord l'histoire du trouble dissociatif en revenant sur les critères diagnostiques du TDI (DSM-5 et CIM-11) pour les comparer avec ceux de l'ancien TPM (Trouble de la Personnalité Multiple) du DSM-III. Nous revenons ensuite sur le concept de « dissociation » en psychiatrie, en soulignant quelques difficultés de traduction et sa plurivocité. Puis, nous proposons de mobiliser le concept des effets de boucle (I. Hacking) pour rendre compte de l'évolution de la nosologie des classifications internationales. Enfin, nous concluons sur les enjeux de la pratique clinique auprès de patients concernés. Le changement de nomination du trouble dissociatif (de TPM à TDI) s'est effectué en réponse à des controverses médico-légales des années 1990. Pour autant, cette nouvelle étiquette diagnostique ne résout ni la problématique épistémologique autour de la dissociation (autour du différentiel névrose/psychose), ni la question des accompagnements thérapeutiques. Le TDI fait aujourd'hui l'objet de deux lectures opposées entre le modèle psychotraumatique et le modèle socio-cognitif. S'ils présentent des écarts et des conceptions irréconciliables de la dynamique des troubles psychiques, ils soulignent tous deux de nombreux points communs à propos du TDI. L'existence de la possibilité de cohabitation de différentes consciences, identités, ou personnalités n'est pas remise en cause. De même, la question du traumatisme est examinée par les tenants des deux modèles. Le succès du TDI pourrait ainsi être en partie expliqué comme un retour de la thèse initiale de la division subjective (Freud, Lacan), incompatible avec l'idée d'un moi fort unifié comme idéal de santé mentale. Pour autant, la logique de « boucle » propre aux classifications des troubles psychiques conduit à reconnaître au TDI une possibilité de nomination par les patients de certains de leurs symptômes. Ainsi, la question n'est pas de déterminer la supériorité d'un modèle « explicatif » du TDI mais d'examiner la dynamique qui a conduit le sujet à être identifié à ce diagnostic. Dans le cas que nous présentons, le TDI est lié à un vécu psychotique chez le patient. Le succès du TDI est contemporain d'interrogations sociales autour des questions d'identité. Les dynamiques du lien social propres au développement de nouvelles nominations ne peuvent cependant pas éclipser un certain réel de la folie se manifestant au travers de phénomènes dissociatifs. L'inconscient comme autre scène peut ainsi éclairer la logique de ces mécanismes, notamment en s'appuyant sur les outils du diagnostic structural proposés par la psychanalyse d'orientation lacanienne. Ces repérages permettent de préciser les conditions d'un accueil et d'une élaboration des troubles sous transfert pour les patients concernés. The aim is to examine the psychopathological and sociocultural implications of DID (Dissociative Identity Disorder), in relation to the way in which the epidemic of "multiple personalities" had dissipated by the end of the 20th century. We begin by tracing the history of dissociative disorder, reviewing the diagnostic criteria of DID (DSM-5 and ICD-11) and comparing them with those of the former MPD (Multiple Personality Disorder) in DSM-III. We then return to the concept of "dissociation" in psychiatry, highlighting some translation difficulties and its plurivocity. Finally, we conclude with a discussion of the issues involved in clinical practice with the patients concerned. The renaming of dissociative disorder (from MPD to DID) was a response to the forensic controversies of the 1990s. However, this new diagnostic label resolves neither the epistemological issues surrounding dissociation (around the neurosis/psychosis differential diagnosis), nor the question of therapeutic accompaniment. Today, DID is the subject of two opposing interpretations: the psychotraumatic model and the social-cognitive model. Although they present irreconcilable differences and conceptions of the dynamics of psychic disorders, they both emphasize many points in common with regard to DID. The possibility of the cohabitation of different consciousnesses, identities, or personalities is not called into question. Similarly, the issue of trauma is examined by proponents of both models. The success of the DID could thus be partly explained as a return to the initial thesis of subjective division (Freud, Lacan), incompatible with the idea of a strongly unified ego as an ideal of mental health. However, the "loop" logic inherent in the classification of psychological disorders means that DID can be seen as a way for patients to describe some of their symptoms. So, the question is not to determine the superiority of an "explanatory" model of DID, but to examine the dynamics that led the subject to be identified with this diagnosis. In the case presented here, DID is linked to the patient's psychotic experience. The success of DID is contemporaneous with social questioning around questions of identity. However, the dynamics of the social bond, specific to the development of a new vocabulary, cannot eclipse a certain reality of suffering manifested through dissociative phenomena. The unconscious as an "autre scène" can shed light on the logic of these mechanisms, notably by drawing on the tools of structural diagnosis proposed by Lacanian psychoanalysis. These insights help to define the conditions under which transference-related disorders can be accepted and elaborated for the patients concerned. [ABSTRACT FROM AUTHOR]

As recently as the late 20th century, Schizophrenia, a category of mental illness with widely varying phenotypic symptoms, was believed by psychobiologists to be a genetically based disorder in which the environment played a limited etiological role. Yet a growing body of evidence indicates a strong correlation between schizophrenia and environmental factors. This theoretical paper explores the relationship between highly elevated rates of schizophrenia in some low-income minority communities worldwide and trauma-related dissociative symptoms that often mimic schizophrenia. Elevated rates of schizophrenia in racially and ethnically isolated, inner-city Black populations are well documented. This paper contains evidence proposing that this amplification in the rate of schizophrenia is mediated by childhood trauma, disorganized attachment, and social defeat. Further, evidence demonstrating how these three variables combine in early childhood to incubate dissociative disorders will also be conveyed. The misdiagnosis of dissociative disorders as schizophrenia is theorized to partially mediate the increased rate of schizophrenia in communities that experience high levels of racial/ethnic discrimination. It is argued that this misdiagnosis is often attributable to cultural misunderstanding and/or a lack of knowledge about dissociative disorders [ABSTRACT FROM AUTHOR]

Functional neurological disorder (FND) has been associated with predisposing psychological factors, including dysregulation of anger-related processes. This paper provides a systematic review of the literature on anger regulation in FND. We evaluated anger-related research on patient self-report, observational, and laboratory based measures in FND. The review also addresses adverse childhood experiences and their relation with anger regulation, and the effects of therapies targeting anger regulation in FND. MEDLINE, EMBASE, and PsycINFO were searched for both quantitative and qualitative research, published in a peer-reviewed journal with a sample size of at least 5 (registered under Prospero protocol CRD42022314340). A total of 2200 articles were identified. After screening, 54 studies were included in this review (k = 20 questionnaire-based studies, k = 12 laboratory studies, k = 21 using other methods, and k = 1 used both questionnaires and other methods) representing data of 2502 patients with FND. Questionnaire-based studies indicated elevated levels of state anger and trait hostility in patients with FND. Laboratory studies showed a higher tendency to avoid social threat cues, attentional bias towards angry faces, difficulties reliving anger, and preoccupation with frustrating barriers among FND patients versus controls. No specific childhood experiences were identified related to anger regulation in FND, and too few small and uncontrolled studies were available (k = 2) to assess the effects of anger-related interventions in FND. The overall quality of the studies was fair (k = 31) to poor (k = 18). Five studies (k = 5) were rated as having a good quality. This review suggests that patients with FND have maladaptive anger regulation compared to individuals without FND. The findings also highlight the need for further research on the prevalence and consequences of anger-related processes in the development, diagnosis and treatment of FND. [ABSTRACT FROM AUTHOR]

Previous empirical studies on the relationship between psychotic symptoms and dissociative disorders focused on auditory hallucinations only or employed limited statistical analyses. We investigated whether the frequency of Schneiderian first rank symptoms (FRS) predicts the presence or absence of a dissociative disorder (DD). Psychiatric in-patients (n = 116) completed measures of dissociation, FRS and general psychological distress (GPD). DD diagnoses were confirmed by multidisciplinary teams or administering the Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised (SCID-D-R). The FRS were recorded in the Multidimensional Inventory of Dissociation (MID) and a mean score obtained for 35 relevant items: Voices arguing, voices commenting, made feelings, made impulses, made actions, influences on body, thought withdrawal, and thought insertion. A global severity index (GSI) of GPD was obtained from the Symptom Checklist–90–Revised (SCL-90-R). Logistic regression models examined whether FRS predict diagnostic classification of patients under a DD (n = 16) or not (n = 100), controlling for GSI. The overall fit of the model was significant (p = .0002). DD was correctly classified using frequency of FRS, controlling for GSI. The latter was moderately associated with FRS (r = 0.56). FRS more than doubled the odds of a DD diagnosis (odds = 2.089; 95% CI = 1.409–3.098; correct classification rate 87.1%). The study provides convincing evidence that FRS are closely related to DDs. FRS should alert clinicians to consider DDs in differential diagnosis of psychiatric in-patients. Future research should analyze whether FRS also predict a diagnosis of schizophrenia or other psychiatric disorders. [ABSTRACT FROM AUTHOR]

Background: The distinction between dissociative disorders (DDs) and schizophrenia spectrum disorders (SSDs) in different categories since DSM-III presumes a clear-cut distinction between both disorders. However, empirical studies did not reveal a clear distinction between the disorders on a symptom level. The aim of the current study was to further examine the overlap and differences in symptoms between DDs and SSDs. Methods: Levels and types of dissociative and psychotic symptoms were compared between 27 DD patients and 51 SSD patients using MANOVA. For a more fine-grained insight, a subgroup analysis was performed with the DD group and 12 individuals with SSD who report many dissociative experiences (SSD-H). Finally, a discriminant analysis was performed to explore if there are symptoms discriminating between the DD group and both SSD groups. Results: Results showed that the DD group experienced higher levels of each type of dissociative symptoms than the total SSD group. The symptoms self-states alters, discontinuities of time, flashbacks, voices, and depersonalization were found to best discriminate between the groups. These differences did not hold in the subgroup analysis between the DD group and SSD-H group, where only differences on the validity scales rare symptoms, attention seeking and factitious behavior were found. Conclusion: It can be stated that none of the dissociative and psychotic symptoms is specific to DDs or SSDs. Therefore it is advisable to be cautious with classifying based on the presence of (certain) symptoms. A transdiagnostic approach towards assessment and treatment, regardless of classification, is indicated.

Background: Previous studies showed that self-stigma is associated with poor clinical outcomes in people with serious mental illness, and is associated with post-traumatic stress disorder (PTSD). However, less is known about self-stigma in people with dissociative symptoms, which are often related to psychological trauma. This study examined whether baseline self-stigma would be associated with dissociative, PTSD and depressive symptoms at post-intervention, after controlling for treatment usage and baseline symptom severity, in a sample of traumatized Chinese adults undertaking a psychoeducation intervention for dissociative symptoms. Methods: We conducted a secondary analysis of data from a 60-day web-based psychoeducation programme. A total of 58 participants who provided data before and after the intervention were included for analysis. Hierarchical regression analyses were conducted. Results: In this highly traumatized, dissociative, and symptomatic help-seeking sample, baseline self-stigma was associated with PTSD (β =.203, p =.032) and depressive (β =.264, p =.025) symptoms at post-intervention, even after controlling for baseline symptom severity, age, location, number of sessions attended in the web-based psychoeducation programme, and use of psychological treatments for PTSD/dissociative symptoms. However, self-stigma was not associated with dissociative symptoms (p =.108). Conclusions: This is the first study showing that self-stigma is a significant predictor of comorbid symptoms (i.e. PTSD and depressive symptoms) in people seeking interventions for dissociative symptoms. The findings that post-traumatic and dissociative symptoms have different relationships to self-stigma also highlight the possibility dissociation might be an independent psychological construct closely associated with trauma, but not merely a PTSD symptom, although further studies are necessary. The preliminary findings call for more efforts to understand, prevent, and address self-stigma in people with trauma-related mental health issues such as dissociative symptoms. Little is known about the clinical impacts of self-stigma in people with trauma and dissociation. Self-stigma predicted post-traumatic and depressive symptoms in people seeking interventions for dissociative symptoms. More efforts to understand and prevent self-stigma in people with trauma-related symptoms are needed. [ABSTRACT FROM AUTHOR]

Introduction: Dialectical behavior therapy-A (DBT-A) is a comprehensive, evidence-based treatment for children and adolescents. To date, there is no empirically validated research for adolescents diagnosed with dissociative disorder (DD) which implies the efficacy of DBT-A. Methods: This was a hospital-based, prospective, open-label trial based on purposive sampling. It was conducted on 40 adolescents diagnosed with DD. They were divided into study group (N = 20) and treatment-as-usual (TAU; N = 20). The TAU group did not receive any psychotherapy apart from medications, but in the study group, they received pharmacotherapy along with DBT-A module (20 sessions). Multidimensional Inventory of Dissociation and Cognitive Emotion Regulation Questionnaire were used as outcome measures before and after the intervention and compared between the two groups. Results: Findings suggested improvement in the spectrum of dissociative symptoms and cognitive emotion regulations (maladaptive) in sample over 8 weeks at the postassessment phase. However, the outcome measures did not reflect significant improvement in the case of adaptive emotion regulation skills at the post-tests. Further, analyses suggested a mild-to-moderate effect size in terms of therapeutic efficacy in the study group compared to TAU. Conclusion: DBT-A intervention module is an effective addition to the management of adolescents diagnosed with DD.

Dissociative disorders have many clinical presentations, one of which is mutism. Hysterical mutism, or functional aphonia (FA), is a functional disorder of the vocal cords presenting as loss of voice with no change in the integrity of the anatomy or physiology of the voice box. Modern understanding of its etiology suggests a strong role for psychosocial stressors. Treatment modalities for this condition are aplenty and vary in mode of administration. This case series describes the use of faradic stimulation in the treatment of FA.

Background: Dissociative disorder is a stress-related disorder usually present in adolescents and younger age groups. It is also accompanied by significant impairment in activity of daily living and family relations. Family environment and use of dysfunctional coping strategies play important roles in the initiation and maintenance of symptoms and this puts a considerable burden on the family. Objectives: This study aims to study the presence of stressors, the role of family environment, the role of family burden, and the use of coping mechanisms in persons with dissociative disorder. Materials and Method: This was a descriptive cross-sectional study in which 100 persons with a dissociative disorder were included after fulfilling inclusion and exclusion criteria from the outpatient department (OPD) of psychiatry. Results: In this study, the major part of the sample were women (87%), most were educated up to 12th standard or less than 12 years of formal education. According to stressors, 44% had family stress/problems. 77% (mostly women) had dissociative stupor. The dissociative disorder caused a considerable degree of burden on the other family members. There was a significant difference in financial burden among caregivers of persons who were married, belonging to rural areas, joint families, and from lower socio-economic classes. There was a significant difference in disruption of routine family activities, and burden in persons having a longer duration of illness. There was a significant difference found in conflict, achievement orientation, and dimensions of family environment between males and females. A significant difference in the venting of emotions, behavioral disengagement, and restraint as a coping strategy between males and females was found. Conclusion: Present study showed dissociative disorder patients cause a considerable degree of burden on family members in terms of leisure, physical, mental, financial, and routine family interrelationship domains. In personal growth and relationship dimensions, the use of dysfunctional coping strategies in the family environment has a causal effect on the symptoms of dissociative disorder patients.

Background: Dissociative disorder is a stress-related disorder usually present in adolescents and younger age groups. It is also accompanied by significant impairment in activity of daily living and family relations. Family environment and use of dysfunctional coping strategies play important roles in the initiation and maintenance of symptoms and this puts a considerable burden on the family. Objectives: This study aims to study the presence of stressors, the role of family environment, the role of family burden, and the use of coping mechanisms in persons with dissociative disorder. Materials and Method: This was a descriptive cross-sectional study in which 100 persons with a dissociative disorder were included after fulfilling inclusion and exclusion criteria from the outpatient department (OPD) of psychiatry. Results: In this study, the major part of the sample were women (87%), most were educated up to 12th standard or less than 12 years of formal education. According to stressors, 44% had family stress/problems. 77% (mostly women) had dissociative stupor. The dissociative disorder caused a considerable degree of burden on the other family members. There was a significant difference in financial burden among caregivers of persons who were married, belonging to rural areas, joint families, and from lower socio-economic classes. There was a significant difference in disruption of routine family activities, and burden in persons having a longer duration of illness. There was a significant difference found in conflict, achievement orientation, and dimensions of family environment between males and females. A significant difference in the venting of emotions, behavioral disengagement, and restraint as a coping strategy between males and females was found. Conclusion: Present study showed dissociative disorder patients cause a considerable degree of burden on family members in terms of leisure, physical, mental, financial, and routine family interrelationship domains. In personal growth and relationship dimensions, the use of dysfunctional coping strategies in the family environment has a causal effect on the symptoms of dissociative disorder patients. [ABSTRACT FROM AUTHOR]

Background: Dissociation is a ubiquitous clinical phenomenon. Dissociative disorders (DD) are primarily characterized by dissociation, and dissociative states are also a criterion for borderline personality disorder (BPD) and the dissociative subtype of post-traumatic stress disorder (PTSD). Dissociative reactions (e.g., depersonalization/derealization or gaps in awareness/memory) across diagnostic categories are believed to be affect contingent and theorized to serve affect regulation functions. What is not clear, however, is how self-reported affect and physiological reactivity unfold within dissociative episodes. To address this issue, the present project aims to investigate the hypothesis (1) whether self-reported distress (as indicated by arousal, e.g., feeling tense/agitated, and/or valence, e.g., feeling discontent/unwell) and physiological reactivity increase before dissociative episodes and (2) whether self-reported distress and physiological reactivity decrease during and after dissociative episodes in a transdiagnostic sample of patients with DD, BPD, and/or PTSD. Methods: We will use a smartphone application to assess affect and dissociation 12 times per day over the course of one week in everyday life. During this time, heart and respiratory rates will be remotely monitored. Afterwards, participants will report affect and dissociative states eight times in the laboratory before, during, and after the Trier Social Stress Test. During the laboratory task, we will continuously record heart rate, electrodermal activity, and respiratory rate, as well as measure blood pressure and take salivary samples to determine cortisol levels. Our hypotheses will be tested using multilevel structural equation models. Power analyses determined a sample size of 85. Discussion: The project will test key predictions of a transdiagnostic model of dissociation based on the idea that dissociative reactions are affect contingent and serve affect regulation functions. This project will not include non-clinical control participants. In addition, the assessment of dissociation is limited to pathological phenomena. [ABSTRACT FROM AUTHOR]

Upto 86% of dissociative individuals engage in non-suicidal self-injury (NSSI). Research suggests that people who dissociate utilize NSSI to regulate posttraumatic and dissociative experiences, as well asrelated emotions. Despite high rates of NSSI, no quantitative study has examined the characteristics, methods, and functions of NSSIwithin a dissociative population. The present study examined thesedimensions of NSSI among dissociative individuals, as well aspotential predictors of intrapersonal functions of NSSI. The sample included 295 participants who indicated experiencing one or more dissociative symptoms and/or having been diagnosed with a trauma- or dissociation-related disorder. Participants were recruited through online trauma- and dissociation- related forums. Approximately 92% of participants endorsed a history of NSSI. The most common methods of NSSI were interfering with wound healing (67%), hitting oneself (66%), and cutting (63%). After controlling for age and gender, dissociation was uniquely associated with cutting, burning, carving, interfering with wound healing, rubbing skin against rough surfaces, swallowing dangerous substances, and other forms of NSSI. Dissociation was correlated with affect regulation, self-punishment,anti-dissociation, anti-suicide, and self-care functions of NSSI;however, after controlling for age, gender, depressive symptoms, emotion dysregulation, and PTSD symptoms, dissociation was no longer associated with any function of NSSI. Instead, only emotion dysregulation was associated with the self-punishment function ofNSSI and only PTSD symptoms were associated with the anti-dissociation function of NSSI. Understanding the unique properties of NSSI among dissociative individuals may improve the treatment of people who dissociate and engage in NSSI. [ABSTRACT FROM AUTHOR]

Aim: Dissociative amnesia is an emblematic psychiatric condition in which patients experience massive memory loss ranging from focal to global amnesia. This condition remains poorly understood and this review aims to investigate the neuroanatomical feature of this disease. Methods: We conducted a systematic review of the scientific literature available on PubMed, up to December 1, 2022, using a combination of keywords referring to dissociative amnesia. We included every scientific report involving patients undergoing a functional imaging procedure. Results: Twenty-two studies met our inclusion criteria (gathering 49 patients). Only one was a controlled study with a large sample. The other 21 were case reports and case series. In resting state, neuroimaging studies mostly showed a hypo-activated right inferolateral prefrontal cortex, associated with limbic hypoactivity and lesser activation of the hippocampal and para-hippocampal structures. The patients also presented abnormal patterns of cerebral activation when performing memory tasks. When testing recognition of memories from the amnestic period, patients showed increased activation across temporal areas (hippocampal and para-hippocampal gyri) and the limbic network. When trying to recollect memories from an amnestic period compared to a non-amnestic period, patients failed to activate these structures efficiently. Most of these patterns tended to return to normal when symptoms resolved. Conclusion: This review identified a paucity of controlled studies in the field of dissociative amnesia neuroimaging, which restricts the extrapolation of results. Patients with dissociative amnesia present a broad prefronto-temporo-limbic network dysfunction. Some of the brain areas implicated in this network might represent potential targets for innovative treatments. [ABSTRACT FROM AUTHOR]

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Although genetic, environmental, autoimmune, and psychological factors are believed to play a role in the onset of alopecia areata (AA), the exact cause remains unknown. This study aimed to investigate whether there are differences in traumatic experiences, dissociative symptoms, and alexithymia levels between groups. Fifty eight patients diagnosed with AA, 58 individuals with dermatological diseases thought to have a low psychosomatic component, and 58 individuals not diagnosed with any chronic disease were included in the study. All participants were assessed using the Childhood Trauma Questionnaire (CTQ-28), Dissociative Experiences Scale (DES), Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), and Toronto Alexithymia Scale (TAS-20). A Structured Clinical Interview for DSM-5 (SCID-5-CV) form was used to exclude additional psychiatric diagnoses. Mean scores on the CTQ-28 scale revealed differences between groups in terms of physical neglect and emotional neglect scores (p < 0.001; p = 0.022; p < 0.001). There were no differences in DES scores between groups (p = 0.085). When compared in terms of TAS-20 and PCL-5 scores, differences were found (p = 0.016; p = 0.024). As a result of this study, it was concluded that physical neglect and emotional neglect could play a significant role in the onset of AA. Alexithymia and traumatic stress disorder symptoms might be more prevalent in patients with AA., (© 2024 Japanese Dermatological Association.)

Abstract Background The Mayer Rokitansky Küster Hauser (MRKH) syndrome is a rare congenital disorder characterized by the absence of uterus and vagina in a patient who is phenotypically a female, with 46 XX karyotypes. It affects 1 in 4000 to 5000 female new-borns. Pulmonary agenesis is a rare association in this MRKH syndrome. Females with MRKH face various mental health issues and psychological disturbances, including dissociative disorder which is a stress-related psychiatric disorder. Dissociative disorder in MRKH syndrome is under-recognized and under-treated. Case presentation A 23-year-old unmarried woman presented to the emergency forabnormal behaviour attack. Recurrent episodes of dissociative convulsions were present most of the time with MRKH syndrome as the pertinent stressor. Both antidepressants and psychotherapy helped to decrease the frequency of dissociative convulsions and come interms with the syndrome. Conclusion This case describes dissociative disorder as the presentation and comorbid condition of MRKH syndrome and the impact of MRKH syndrome on the patient. We attempt to explain the occurrence of dissociative disorder in MRKH syndrome and the results of under-recognition and under-treatment of the same. We aim to highlight the presence of commonly treatable conditions associated with a rare syndrome and its effect when untreated and unrecognized.

Knowledge of factors related to patients' and primary caregivers' health-seeking behaviour is required for a complete early intervention for the management of mental illness. Previous research has found that men are more likely to seek care and that a considerable proportion of patients seek help from native healers before obtaining psychiatric help. The goal of this study was to see if there had been any changes in the paths to psychiatric care, as well as the socio-demographic characteristics that were linked to early help-seeking behaviour among patients with mental illnesses in metropolitan eastern India. Method: The researchers utilised a cross-sectional study design. A face-to-face interview was used to collect data using the WHO Encounter Form. Using a successive sample technique, patients with various diagnoses of mental illness undergoing Psychiatry outpatient therapy at a tertiary care medical college were included in the study. Results: In terms of gender, ladies (53.3%) were seen to use psychiatric services more than males (46.7%) from an urban or semi-urban background. For dissociative disorders, the median time from onset to first contact with a care provider was 0.1 years; 0.3 years for mood episodes; 0.6 years for anxiety disorders; one year for psychotic disorders; and seven years for Substance Use Disorders (SUD). However, interaction with current psychiatric services took an average of six months for dissociation; 3.5 years for mood disorders; three years for anxiety disorders; six years for psychotic disorders; and a maximum of seventeen years for SUD. Participants in the study who had a family history of mental illness sought care more quickly (OR = 4.3, 95 percent CI 1.19 to 7.11, P = 0.03). The fact that 73 percent of patients have a GP or mental health professional as their first point of contact for various mental diseases is good. Higher education status, urban background, dwelling closer to the mental health centre, and having a biological attribution model for psychological illness were the other clinical and demographic characteristics important for quicker paths to mental health treatment. Conclusions: In most cases of psychosis and SUD (substance use disorders), there is still a significant delay in receiving modern psychiatric therapy. The number of initial contacts with Native Healers ha s decreased. The majority of people said mental illness was caused by environmental or biological factors. Education and scientific information regarding mental health have aided the process of seeking treatment, and there should be a provision of training programmes for family physicians and community health professionals to facilitate the process of help-seeking behavior of psychiatric patients in the Indian subcontinent.

AimDissociative amnesia is an emblematic psychiatric condition in which patients experience massive memory loss ranging from focal to global amnesia. This condition remains poorly understood and this review aims to investigate the neuroanatomical feature of this disease.MethodsWe conducted a systematic review of the scientific literature available on PubMed, up to December 1, 2022, using a combination of keywords referring to dissociative amnesia. We included every scientific report involving patients undergoing a functional imaging procedure.ResultsTwenty-two studies met our inclusion criteria (gathering 49 patients). Only one was a controlled study with a large sample. The other 21 were case reports and case series. In resting state, neuroimaging studies mostly showed a hypo-activated right inferolateral prefrontal cortex, associated with limbic hypoactivity and lesser activation of the hippocampal and para-hippocampal structures. The patients also presented abnormal patterns of cerebral activation when performing memory tasks. When testing recognition of memories from the amnestic period, patients showed increased activation across temporal areas (hippocampal and para-hippocampal gyri) and the limbic network. When trying to recollect memories from an amnestic period compared to a non-amnestic period, patients failed to activate these structures efficiently. Most of these patterns tended to return to normal when symptoms resolved.ConclusionThis review identified a paucity of controlled studies in the field of dissociative amnesia neuroimaging, which restricts the extrapolation of results. Patients with dissociative amnesia present a broad prefronto-temporo-limbic network dysfunction. Some of the brain areas implicated in this network might represent potential targets for innovative treatments.

Functional dissociative seizures (FDS) are paroxysmal and episodic events associated with motor, sensory, mental, or autonomic manifestations, which resemble epileptic seizures but are not caused by epileptogenic activity. FDSs affect approximately 30% of patients attending specialized epilepsy centers and constitute a severe mental health problem. Patients with FDSs also have a high frequency of other psychiatric comorbidities like depression and anxiety disorders, particularly trauma and post-traumatic stress disorder. It has been postulated that FDSs are essentially dissociations that operate as an evitative psychological mechanism to deal with traumas. In this manuscript, we carried out a state-of-the-art review to provide a critical approach to the extensive literature about FDS, focusing on the relationship with trauma, post-traumatic stress disorder, dissociation, and the neurobiology of these phenomena.

Background: Borderline Personality Disorder (BPD) is frequently complicated by the presence of dissociative symptoms. Pathological dissociation is linked with earlier and more severe trauma exposure, emotional dysregulation and worse treatment outcomes in Posttraumatic Stress Disorder and Dissociative Disorders, with implications for BPD. Objective: A systematic scoping review was conducted to assess the extent of current literature regarding the impact of dissociation on BPD and to identify knowledge gaps. Methods: Four electronic databases (MEDLINE, APA PsycINFO, EMBASE, CINAHL Plus) were searched, and English peer-reviewed studies with adults with BPD were included, following Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) extension for scoping reviews (PRISMA-ScR) 2018 guidelines. Results: Most of the 70 included studies were observational (98%) with first authors from Germany (59%). Overall, dissociation was associated with increased BPD symptom severity, self-harm and reduced psychotherapy treatment response; findings regarding suicide risk were mixed. Dissociation was associated with working memory and cognitive deficits, decreased pain perception, altered body ownership, no substance abuse or the abuse of sedative substances, increased fantasy proneness, personality fragmentation, fearful attachment, dream anxiety, perceived stress and altered stress responses, increased cumulative body mass index, decreased water consumption, several neurological correlates and changes in gene expression. Conclusion: BPD with significant dissociative symptoms may constitute a more severe and at-risk subgroup of BPD patients. However, there are significant research gaps and methodological issues in the area, including the possibility of unrecognized Dissociative Disorders in BPD study populations confounding results. Further studies are needed to better understand the impact of dissociation on BPD course and treatment, and to clarify the most appropriate assessment tools for clinical practice. In addition, interventional studies are needed to develop dissociation-specific BPD treatments to determine whether targeting dissociation in BPD can improve treatment outcomes. [ABSTRACT FROM AUTHOR]

Knowledge of factors related to patients' and primary caregivers' health-seeking behaviour is required for a complete early intervention for the management of mental illness. Previous research has found that men are more likely to seek care and that a considerable proportion of patients seek help from native healers before obtaining psychiatric help. The goal of this study was to see if there had been any changes in the paths to psychiatric care, as well as the socio-demographic characteristics that were linked to early help-seeking behaviour among patients with mental illnesses in metropolitan eastern India. Method: The researchers utilised a cross-sectional study design. A face-to-face interview was used to collect data using the WHO Encounter Form. Using a successive sample technique, patients with various diagnoses of mental illness undergoing Psychiatry outpatient therapy at a tertiary care medical college were included in the study. Results: In terms of gender, ladies (53.3%) were seen to use psychiatric services more than males (46.7%) from an urban or semi-urban background. For dissociative disorders, the median time from onset to first contact with a care provider was 0.1 years; 0.3 years for mood episodes; 0.6 years for anxiety disorders; one year for psychotic disorders; and seven years for Substance Use Disorders (SUD). However, interaction with current psychiatric services took an average of six months for dissociation; 3.5 years for mood disorders; three years for anxiety disorders; six years for psychotic disorders; and a maximum of seventeen years for SUD. Participants in the study who had a family history of mental illness sought care more quickly (OR = 4.3, 95 percent CI 1.19 to 7.11, P = 0.03). The fact that 73 percent of patients have a GP or mental health professional as their first point of contact for various mental diseases is good. Higher education status, urban background, dwelling closer to the mental health centre, and having a biological attribution model for psychological illness were the other clinical and demographic characteristics important for quicker paths to mental health treatment. Conclusions: In most cases of psychosis and SUD (substance use disorders), there is still a significant delay in receiving modern psychiatric therapy. The number of initial contacts with Native Healers ha s decreased. The majority of people said mental illness was caused by environmental or biological factors. Education and scientific information regarding mental health have aided the process of seeking treatment, and there should be a provision of training programmes for family physicians and community health professionals to facilitate the process of help-seeking behavior of psychiatric patients in the Indian subcontinent. [ABSTRACT FROM AUTHOR]

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) revised the diagnostic criteria for dissociative identity disorder (DID) to more accurately reflect the symptom profile of DID patients. No study has examined how this change affects clinical diagnosis of DID. The present study examined clinician reports of patient symptoms in relation to DSM-IV-TR and DSM-5 DID diagnostic criteria. Data were analyzed from 169 clinicians who participated in the Treatment of Patients with Dissociative Disorders Network Study with a patient they assigned a DID diagnosis. Clinicians evaluated their patients with respect to DSM-IV-TR and DSM-5 DID diagnostic criteria. Researchers determined a clinician-assigned DID diagnosis as "accurate" when the patient's reported dissociative symptoms matched DSM-IV-TR and/or DSM-5 criteria for DID. Most of the clinicians (95.27%) accurately diagnosed DID. Of those accurately diagnosed, 83.85% of patients met DSM-IV-TR and DSM-5 DID criteria, 9.94% only met DSM-IV-TR DID criteria, and 6.21% only met DSM-5 DID criteria. Further examination of responses suggested that possible idiomatic responses to the negative wording of the DSM-5 exclusionary criteria might have accounted for the DSM-IV-TR appearing to fit for a greater number of cases in this study. Changes in the DSM criteria for DID did not substantially change the frequency or accuracy of assigned DID diagnoses, but the removal of the requirement in DSM-5 that self-states regularly take control of an individual's behavior slightly increased the number of individuals meeting criteria for DID. [ABSTRACT FROM AUTHOR]

Hemolacria is a rare manifestation of dissociative disorder. Aim of index report was to present clinical findings in a 13-year old female and explore the socio-cultural meaning associated with this phenomenon. Eclectic psychotherapeutic approach was implemented to address the symptoms. To conclude, physical symptoms presenting in dissociative disorder may be conceptualized in socio-cultural context.

Although no psychotropic medication is specifically effective for dissociative symptoms, certain abusive substances can markedly alter these symptoms. Regarding psychotropic medications, a positive response was observed in certain patients with dissociative symptoms who also have attention deficit hyperactivity disorder (ADHD), for which methylphenidate extended release (MER) was administered. A is a female in her twenties and has dissociative identity disorder (DID) and ADHD. Primary personality A1 is usually on duty but always on guard, as her other personality, A2, often attempts to disturb A1. A1's job is also hampered by careless mistakes due to her ADHD. After A was put on MER, A1 felt that A2's presence suddenly faded away while on duty and she could focus better on her job as a result. B is a middle-aged male with DID and ADHD whose life is disturbed by the occasional appearance of a violent and disruptive personality. When MER was administered for his ADHD symptoms, it helped him stay alert, and his violent episodes decreased significantly. C is a young male university student with occasional dissociative "foggy" episodes that leave him with amnesia. He is diagnosed with depersonalization-derealization disorder (DDD) and ADHD. After MER was administered for his ADHD symptoms, his dissociative episodes diminished markedly, and his job performance improved significantly as a result. When MER is administered for patients with dissociative conditions and comorbid ADHD, it appears to have positive effects on their dissociative symptoms, including increasing the threshold separating different personalities or diminishing depersonalization symptoms., (© 2025 The Author(s). Neuropsychopharmacology Reports published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Neuropsychopharmacology.)

Background Dissociative disorders (DDs) are characterized by interruptions of identity, thought, memory, emotion, perception, and consciousness. Patients with DDs are at high risk for engaging in dangerous behaviours, such as self-harm and suicidal acts; yet, only between 28% and 48% of individuals with DDs receive mental health treatment. Patients that do pursue treatment are often misdiagnosed, repeatedly hospitalized, and experience disbelief from providers about their trauma history and dissociative symptoms. Lack of dissociation-specific treatment can result in poor quality of life, severe symptoms requiring utilization of hospitalization and intensive outpatient treatment, and high rates of disability. Objective Given the extensive and debilitating symptoms experienced by individuals with DDs and the infrequent utilization of treatment, the current study explored barriers to accessing and continuing mental health treatment for individuals with dissociative symptoms and DDs. Method A total of 276 participants with self-reported dissociative symptoms were recruited via online social media platforms. Participants completed a survey which featured 35 possible barriers to accessing treatment and 45 possible reasons for discontinuing treatment, along with open text boxes for adding barriers/reasons that were not listed. Results Results showed 97% of participants experienced one or more barriers to accessing treatment (M = 9 barriers) and 92% stopped treatment with a provider due to at least one of the reasons captured in the survey (e.g. limited insurance coverage, poor therapeutic alliance, disbelief from providers, etc.; M = 7 barriers). Conclusions The most frequently endorsed barriers were structural barriers, such as those related to finances, insurance, and lack of provider availability. It is imperative more service providers are trained to treat dissociation and that insurers and health care systems recognize the need for specialized, dissociation-focused treatment.

Background Most individuals with dissociative disorders (DDs) report engaging in self-injury. Objective The present study aimed to understand the reasons for self-injury among a clinical sample of 156 DD patients enrolled in the TOP DD Network study. Method Participants answered questions about self-injury, including a prompt asking how often they are aware of the reasons they have urges to self-injure, as well as a prompt asking them to list three reasons they self-injure. Results Six themes of reasons for self-injury, each with subthemes, were identified in the qualitative data: (1) Trauma-related Cues, (2) Emotion Dysregulation, (3) Stressors, (4) Psychiatric and Physical Health Symptoms, (5) Dissociative Experiences, and (6) Ineffective Coping Attempts. Participants reported that they were able to identify their reasons for self-injuring sometimes (60.26%) or almost always (28.85%), with only 3.20% unable to identify any reasons for their self-injury. Conclusion Results suggest that the vast majority of DD patients (92.31%) reported being at least partially unaware of what leads them to have self-injury urges, and many individuals with DDs experience some reasons for self-injury that are different from those with other disorders. The treatment implications of these findings are discussed.

Background Dissociative disorder (DD) patients report high rates of self-injury. Previous studies have found dissociation and self-injury to be related to emotional distress. To the best of our knowledge, however, the link between emotion dysregulation and self-injury has not yet been examined within a DD population. Objective The present study investigated relations between emotion dysregulation, dissociation, and self-injury in DD patients, and explored patterns of emotion dysregulation difficulties among DD patients with and without recent histories of self-injury. Method We utilized linear and logistic regressions and t-test statistical methods to examine data from 235 patient-clinician dyads enrolled in the TOP DD Network Study. Results Analyses revealed emotion dysregulation was associated with heightened dissociative symptoms and greater endorsement of self-injury in the past six months. Further, patients with a history of self-injury in the past six months reported more severe emotion dysregulation and dissociation than those without recent self-injury. As a group, DD patients reported the greatest difficulty engaging in goal-directed activities when distressed, followed by lack of emotional awareness and nonacceptance of emotional experiences. DD patients demonstrated similar patterns of emotion dysregulation difficulties irrespective of recent self-injury status. Conclusions Results support recommendations to strengthen emotion regulation skills as a means to decrease symptoms of dissociation and self-injury in DD patients.

Dissociative identity disorder is not new. Yet, there exists a paucity of emic research on the topic due to its covert nature. In this research, the disorder is presented and understood from the perspective of the person who must live with it on a daily basis. Through the newly discovered theory of discovering and uncovering, the reader will gain a more nuanced perspective of the disorder.

Background: Dissociative disorder in adults is caused by traumatic life events. Various cultural backgrounds specify the multiple types of stressful or undesirable life events. Dissociative phenomena have a pervasive relationship with traumatic stress derived from any negative life event. The inability to cope with the stressors disrupted their behaviors or daily functioning beside that any traumatic life events considered a triggering factor of their mental illness. The interrelation between these two variables; coping mechanism and life event determine the treatment outcome, relapse rate, and prognosis of the dissociative disorder. Aim: The aim of this study is to compare the coping strategies and stressful life events between person with dissociative disorder and normal control group. Materials and Methods: Seventy respondents (35 of dissociative disorders and 35 of general population) were reviewed, and the two groups were compared with respect to their sociodemographic profile, life events, and coping mechanisms. Results: Respondents with dissociative disorders have experienced a higher number of stressful life events with dysfunctional coping mechanism. Conclusion: Stressful life events lead to develop dysfunctional coping pattern in the persons with dissociative disorder.

Dissociative disorders are a common and frequently undiagnosed group of psychiatric disorders, characterized by disruptions in the normal integration of awareness, personality, emotion and behavior. The available evidence suggests that these disorders arise from an interaction between genetic vulnerability and stress, particularly traumatic stress, but the attention paid to the underlying genetic diatheses has been sparse. In this paper, the existing literature on the molecular genetics of dissociative disorders, as well as of clinically significant dissociative symptoms not reaching the threshold of a disorder, is reviewed comprehensively across clinical and non-clinical samples. Association studies suggest a link between dissociative symptoms and genes related to serotonergic, dopaminergic and peptidergic transmission, neural plasticity and cortisol receptor sensitivity, particularly following exposure to childhood trauma. Genome-wide association studies have identified loci of interest related to second messenger signaling and synaptic integration. Though these findings are inconsistent, they suggest biologically plausible mechanisms through which traumatic stress can lead to pathological dissociation. However, methodological concerns related to phenotype definition, study power, and correction for the confounding factors limit the value of these findings, and they require replication and extension in studies with better design. [ABSTRACT FROM AUTHOR]

Ganser syndrome is a rare and historically controversial disorder characterized by approximately correct (but not quite correct) answers to simple questions (called vorbeigehen or vorbeireiden), visual and auditory hallucinations, and "clouded consciousness" or encephalopathy. These symptoms usually co-occur with various functional neurological symptoms. We present the case of a 53-year-old man who arrived as a stroke alert with sudden-onset left-sided weakness and numbness, one day after being reported to police by a neighbor for indecent exposure. During his emergency department evaluation, the examiner noticed that he exhibited an inconsistent bedside mental status examination, responding with approximate but not quite correct answers that indicated awareness of his own thought content, in addition to reporting nondescript hallucinations. He had one previous hospitalization in our records with a similar presentation but without these characteristic mental status changes. He serves as his own control, demonstrating that fear of punishment or legal action was necessary to elicit a presentation of Ganser syndrome in his case., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: Juan G. Ochoa is a consultant for Compumedics USA, Inc., (Copyright © 2024, Stokes et al.)

Pervasive pregnancy denial is a misunderstood reproductive anomaly which compromises the health of both mother and the developing fetus. Because in extreme cases, the death of the neonate at the hands of his/her mother has criminal repercussions, research has attempted to explain the origins of this clinical phenomenon. The purpose of this review is to analyze the evolution of understanding the association between pregnancy denial and neonaticide. This paper identifies the consistent similarities in symptom presentation, particularly dissociation, when a denied pregnancy ends with the death of the newborn. The common thread across the progression of the literature over time serves as a foundation for considering the development of diagnostic criteria for future inclusion in the Diagnostic and Statistical Manual of Mental Disorders. This paper reviews the seminal research from 1969 to current research up to 2020 addressing pregnancy denial and its connection to neonaticide. Peer reviewed and published articles related to key terms around "pregnancy denial," "pregnancy concealment," "neonaticide," and "dissociation" were retrieved from major databases such as PubMed, PsychINFO, JSTOR, ProQEST, ScienceDirect, and Google Scholar. Reference lists of relevant articles were also scanned to search for further papers pertaining to similarities in symptom presentation across demographic profiles. Papers were excluded if they were not available in English, or if they did not contribute to identifying consistencies in clinical presentation when a pregnancy is denied. There are clear repetitive markers that occur across studies which pertain not only to the frequent absence of certain expected indicators of pregnancy, (i.e. no morning sickness, weight gain, or sensations of fetal movement), but also the misattribution of pregnancy-related symptoms, and the consistent experience of a dissociative episode while giving birth that can unintentionally result in neonaticide. This paper concludes that dissociation is a consistently seen symptom in pervasive pregnancy denial. Dissociation, in addition to other commonly seen symptoms across cases, suggests specific diagnostic criteria that lend themselves to inclusion in the Diagnostic and Statistical Manual of Mental Disorders. [ABSTRACT FROM AUTHOR]

Background: The Mayer Rokitansky Küster Hauser (MRKH) syndrome is a rare congenital disorder characterized by the absence of uterus and vagina in a patient who is phenotypically a female, with 46 XX karyotypes. It affects 1 in 4000 to 5000 female new-borns. Pulmonary agenesis is a rare association in this MRKH syndrome. Females with MRKH face various mental health issues and psychological disturbances, including dissociative disorder which is a stress-related psychiatric disorder. Dissociative disorder in MRKH syndrome is under-recognized and under-treated. Case presentation: A 23-year-old unmarried woman presented to the emergency forabnormal behaviour attack. Recurrent episodes of dissociative convulsions were present most of the time with MRKH syndrome as the pertinent stressor. Both antidepressants and psychotherapy helped to decrease the frequency of dissociative convulsions and come interms with the syndrome. Conclusion: This case describes dissociative disorder as the presentation and comorbid condition of MRKH syndrome and the impact of MRKH syndrome on the patient. We attempt to explain the occurrence of dissociative disorder in MRKH syndrome and the results of under-recognition and under-treatment of the same. We aim to highlight the presence of commonly treatable conditions associated with a rare syndrome and its effect when untreated and unrecognized. [ABSTRACT FROM AUTHOR]

• Stress response changes seem to be associated with the emergence and persistence of dissociative and conversion disorders. • High autonomic arousal affects individuals with dissociative and conversion disorders. • Patients with dissociation symptom and history of acute trauma show reduced cortisol secretion and autonomous deactivation. Dissociative disorders (DD) and conversion disorders (CD) are frequent in general and psychiatric populations. Some evidence suggest that the hypothalamic-pituitary axis (HPA) and autonomic nervous system (ANS) are dysregulated in both disorders. We carried out a systematic review of the literature to summarize the existing knowledge on the stress response, via HPA and/or ANS, in patients with DD, CD, or dissociative symptoms. We systematically searched Medline and Web of Science using the Medical Subject Headings related to stress axis, CD, DD, and dissociative symptoms following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results suggest that in participants without psychiatric history, high cortisol secretion is related to high dissociation scores. Conversely the stress system might be blunted in patients with post-traumatic stress disorder who develop dissociative symptoms. Stress response changes seem to be associated with the emergence and persistence of dissociative and conversion disorders. Hence, monitoring the stress response and examining closely the history of stress exposure in DD and CD should be encouraged in future larger studies. [ABSTRACT FROM AUTHOR]

Ganser syndrome (GS) is one of a few eponyms that have survived in psychiatry until the present day. GS is a little-known and rare disorder. It is most often described as a response to a stressor (e.g. incarceration), that is why it is an important issue in forensic psychiatry. Organic causes are taken into consideration. The basic symptoms of the syndrome are: approximate answers, visual and auditory hallucinations, clouding of consciousness and conversion symptoms. Additionally, patients may perform activities in an awry manner and suffer from insensitivity to painful stimuli. GS is usually acute and subsides spontaneously. Usually patients do not remember they had an episode of the disease. Diagnostic criteria of GS are imprecise and its classification has been changed over the years. GS was not listed in the DSM-5 classification, although in the DSM-IV it was classified as a dissociative disorder. Currently some authors tend to classify it rather as a factitious disorder. WHO (ICD-10 and ICD-11) classifies GS as a dissociative and conversion disorder, which seems to be appropriate in the light of current knowledge. The presented case report describes a patient with a nearly identical pattern of full-blown GS, which occurred twice. The symptoms appeared shortly after the patient was incarcerated. The course of the disorder was chronic and recurrent. The patient was insensitive to pain stimuli. Somatic causes were excluded in the diagnostic process. [ABSTRACT FROM AUTHOR]

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Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)