Background: Dissociation may be defined as a psychopathological process in which an individual’s psyche splits into two or more parts. The division of personality is a key element in trauma, especially if the patient...Background: Dissociation may be defined as a psychopathological process in which an individual’s psyche splits into two or more parts. The division of personality is a key element in trauma, especially if the patient is not able to cope with it. At least one part of personality may be relatively able to understand and function in the objective reality, whilst other part(s) of the psyche may be more or less disorganized, dysfunctional and less able to understand the truth. Methods: literature review;conceptualization of dissociation, dissociative disorders and partial psychosis from medical and philosophical perspective. Conclusion: The core of dissociation and dissociative disorders is usually psychological trauma, especially emotional trauma, although some individuals may experience dissociation without any obvious cause or trigger. Carefully designed trauma-focused psychotherapy and psychosocial support are considered and must be further studied as the cornerstone of multidisciplinary approach in the treatment of dissociative disorders. Dissociative identity disorder in its severe form may resemble characteristics of partial psychosis. Some patients suffering from partial psychosis have narcissistic personality traits, such as shamelessness, magical thinking, arrogance, envy, entitlement, exploitation and bad boundaries, and therefore, developing healthy self-love, which is based on healthy self-criticism, realistic thinking, humility, gratefulness, democratic behavior, altruism and good boundaries, might be helpful for these patients.展开更多
Borderline personality disorder, conversion disorder and obsessive compulsive disorder frequently have dissociative symptoms. The literature has demonstrated that the level of dissociation might be correlated with the...Borderline personality disorder, conversion disorder and obsessive compulsive disorder frequently have dissociative symptoms. The literature has demonstrated that the level of dissociation might be correlated with the severity of obsessive compulsive disorder(OCD) and that those not responding to treatment had high dissociative symptoms. The structured clinical interview for DSM-IV dissociative disorders, dissociation questionnaire, somatoform dissociation questionnaire and dissociative experiences scale can be used for screening dissociative symptoms and detecting dissociative disorders in patients with OCD. However, a history of neglect and abuse during childhood is linked to a risk factor in the pathogenesis of dissociative psychopathology in adults. The childhood trauma questionnaire-53 and childhood trauma questionnaire-40 can be used for this purpose. Clinicians should not fail to notice the hidden dissociative symptoms and childhood traumatic experiences in OCD cases with severe symptoms that are resistant to treatment. Symptom screening and diagnostic tools used for this purpose should be known. Knowing how to treat these pathologies in patients who are diagnosed with OCD can be crucial.展开更多
The foreign accent syndrome(FAS) is a rare speech disorder, characterised by the appearance of a new accent, different from the speaker's native language and perceived as foreign by others. In the majority of pati...The foreign accent syndrome(FAS) is a rare speech disorder, characterised by the appearance of a new accent, different from the speaker's native language and perceived as foreign by others. In the majority of patients, FAS is secondary to focal brain damage caused by stroke or other neurological disorders. Infrequently, FAS has been reported in association with psychiatric disorders, including dissociative or conversion disorders. The case of a young woman with recurrent episodes of speaking with a foreign accent is described. Repeated neurological examinations, imaging and electroencephalography did not reveal any brain abnormality. However, there was a history of a difficult childhood, alcohol dependence in the father, parental discord, alleged sexual abuse in the past, interpersonal difficulties and parental death. Episodes were precipitated by stressful life circumstances and resolved spontaneously, or with supportive treatment. She had additional "suspect" symptoms such as non-epileptic seizures, aphonia and motor paralysis. All these features indicated that a dissociative disorder was involved in the genesis of her FAS. The influence of external factors such as the media was unclear. Generally biological factors have been implicated in the onset of FAS, but the presentation in this young woman suggests that psychological factors such as personality, trauma, stressful life events and psychiatric disorder; familial factors such as parental discord and parental death and family conflicts; and, social factors such the possible influence of the media may also be involved in the production of foreign accents by patients.展开更多
Objective: To observe the conversion disorder in a neurological emergency department. Methods: It is common that the initial approach to this patients include the use of various diagnostic exams. In this series we rev...Objective: To observe the conversion disorder in a neurological emergency department. Methods: It is common that the initial approach to this patients include the use of various diagnostic exams. In this series we reviewed 94 patients that arrived a neurological emergency room in a 3 year period. Results: 72 patients were females (76%), and the initial presumptive diagnosis were: neurovascular syndrome in 36 patients (38.3%), convulsive disorder in 20 patients (21.28%), and conversive disorder in 8 patients (8.51%). 82 patients had motor symptoms and 61 sensitive symptoms. 88 patients (93%) required neuroimaging studies, 77 (81%) patients underwent through basic biochemical panels. Other tests performed were:electroencephalogram in 12 patients (12.77%), electromyography in 11 patients (11.7%), lumbar punction in 8 patients (8.04%) and regarding the medical consult in the care of these patients 11 were evaluated by 1 specialists, 35 (37.2%) by 2 different specialties, 42 (44.63%) patients required evaluation by 3, and 6 patients (6.38%) required evaluation by 4 different specialties. Conclusions: Based on this data, we conclude that conversion disorders require a lot of resources in the emergency room and that the similarities with neurological diseases demands a complete workup including expensive diagnostic tools. However, this patients can be discharged safely without requiring hospitalization.展开更多
To facilitate gathering information during a psychiatric interview, some psychiatrists advocate augmenting the interview using drugs. Rather than barbiturates, benzodiazepines have been used for drug-assisted intervie...To facilitate gathering information during a psychiatric interview, some psychiatrists advocate augmenting the interview using drugs. Rather than barbiturates, benzodiazepines have been used for drug-assisted interviews. Dissociative amnesia is one of the indications for these interviews. Herein, we present the case of a 15-year-old female who was diagnosed as having dissociative amnesia because of conflicts with her friends. She was administered a Iorazepam-assisted interview to aid recovery of her memories. In this case, a small dose of Iorazepam was sufficient to recover her memories without any adverse effects.展开更多
In order to study the nature of gas hydrate in porous media,the formation and dissociation processes of methane hydrate in loess were investigated.Five cooling rates were applied to form methane hydrate.The nucleation...In order to study the nature of gas hydrate in porous media,the formation and dissociation processes of methane hydrate in loess were investigated.Five cooling rates were applied to form methane hydrate.The nucleation times of methane hydrate formation at each cooling rate were measured for comparison.The experimental results show that cooling rate is a significant factor affecting the nucleation of methane hydrate and gas conversion.Under the same initial conditions,the faster the cooling rate,the shorter the nucleation time,and the lower the methane gas conversion.Five dissociating temperatures were applied to conduct the dissociation experiment of methane hydrate formed in loess.The experimental results indicated that the temperature evidently controlled the dissociation of methane hydrate in loess and the higher the dissociating temperature,the faster the dissociating rates of methane hydrate.展开更多
BACKGROUND Dissociation,which is defined as the failure to associate consciousness,memory,identity,emotion,perception,body representation,motor control,and behavior into an integrated whole,has long been assumed to be...BACKGROUND Dissociation,which is defined as the failure to associate consciousness,memory,identity,emotion,perception,body representation,motor control,and behavior into an integrated whole,has long been assumed to be generated by trauma.If dissociation is a product of trauma exposure,then dissociation would be a major mental health outcome observed in studies of disaster survivors.Although some studies have examined dissociation in disasters,no systematic literature reviews have been conducted to date on the topic.AIM To systematically evaluate the literature on the association between disaster and dissociation to determine the prevalence and incidence of dissociation after exposure to disaster and further examine their relationship.METHODS EMBASE,Medline,and PsychINFO were searched from inception to January 1,2019 to identify studies examining dissociative disorders or symptoms related to a disaster in adult or child disaster survivors and disaster responders.Studies of military conflicts and war,articles not in English,and those with samples of 30 or more participants were excluded.Search terms used were“disaster*”and dissociation(“dissociat*,”“multiple personality,”“fugue,”“psychogenic amnesia,”“derealization,”and“depersonalization”).Reference lists of identified articles were scrutinized to identify studies for additional articles.RESULTS The final number of articles in the review was 53,including 36 articles with samples of adults aged 18 and above,5 of children/adolescents under age 18,and 12 of disaster workers.Included articles studied several types of disasters that occurred between 1989 and 2017,more than one-third(38%)from the United States.Only two studies had a primary aim to investigate dissociation in relation to disaster and none reported data on dissociative disorders.All of the studies used self-report symptom scales;none used structured interviews providing full diagnostic assessment of dissociative disorders or other psychopathology.Several studies mixed exposed and unexposed samples or did not differentiate outcomes between exposure groups.Studies examining associations between dissociation and disaster exposure have been inconclusive.The majority(75%)of the studies compared dissociation with posttraumatic stress,with inconsistent findings.Dissociation was found to be associated with a wide range of other psychiatric disorders,symptoms,and negative emotional,cognitive,and functional states.CONCLUSION The studies reviewed had serious methodological limitations including problems with measurement of psychopathology,sampling,and generation of unwarranted conclusions,precluding conclusions that dissociation is an established outcome of disaster.展开更多
文摘Background: Dissociation may be defined as a psychopathological process in which an individual’s psyche splits into two or more parts. The division of personality is a key element in trauma, especially if the patient is not able to cope with it. At least one part of personality may be relatively able to understand and function in the objective reality, whilst other part(s) of the psyche may be more or less disorganized, dysfunctional and less able to understand the truth. Methods: literature review;conceptualization of dissociation, dissociative disorders and partial psychosis from medical and philosophical perspective. Conclusion: The core of dissociation and dissociative disorders is usually psychological trauma, especially emotional trauma, although some individuals may experience dissociation without any obvious cause or trigger. Carefully designed trauma-focused psychotherapy and psychosocial support are considered and must be further studied as the cornerstone of multidisciplinary approach in the treatment of dissociative disorders. Dissociative identity disorder in its severe form may resemble characteristics of partial psychosis. Some patients suffering from partial psychosis have narcissistic personality traits, such as shamelessness, magical thinking, arrogance, envy, entitlement, exploitation and bad boundaries, and therefore, developing healthy self-love, which is based on healthy self-criticism, realistic thinking, humility, gratefulness, democratic behavior, altruism and good boundaries, might be helpful for these patients.
文摘Borderline personality disorder, conversion disorder and obsessive compulsive disorder frequently have dissociative symptoms. The literature has demonstrated that the level of dissociation might be correlated with the severity of obsessive compulsive disorder(OCD) and that those not responding to treatment had high dissociative symptoms. The structured clinical interview for DSM-IV dissociative disorders, dissociation questionnaire, somatoform dissociation questionnaire and dissociative experiences scale can be used for screening dissociative symptoms and detecting dissociative disorders in patients with OCD. However, a history of neglect and abuse during childhood is linked to a risk factor in the pathogenesis of dissociative psychopathology in adults. The childhood trauma questionnaire-53 and childhood trauma questionnaire-40 can be used for this purpose. Clinicians should not fail to notice the hidden dissociative symptoms and childhood traumatic experiences in OCD cases with severe symptoms that are resistant to treatment. Symptom screening and diagnostic tools used for this purpose should be known. Knowing how to treat these pathologies in patients who are diagnosed with OCD can be crucial.
文摘The foreign accent syndrome(FAS) is a rare speech disorder, characterised by the appearance of a new accent, different from the speaker's native language and perceived as foreign by others. In the majority of patients, FAS is secondary to focal brain damage caused by stroke or other neurological disorders. Infrequently, FAS has been reported in association with psychiatric disorders, including dissociative or conversion disorders. The case of a young woman with recurrent episodes of speaking with a foreign accent is described. Repeated neurological examinations, imaging and electroencephalography did not reveal any brain abnormality. However, there was a history of a difficult childhood, alcohol dependence in the father, parental discord, alleged sexual abuse in the past, interpersonal difficulties and parental death. Episodes were precipitated by stressful life circumstances and resolved spontaneously, or with supportive treatment. She had additional "suspect" symptoms such as non-epileptic seizures, aphonia and motor paralysis. All these features indicated that a dissociative disorder was involved in the genesis of her FAS. The influence of external factors such as the media was unclear. Generally biological factors have been implicated in the onset of FAS, but the presentation in this young woman suggests that psychological factors such as personality, trauma, stressful life events and psychiatric disorder; familial factors such as parental discord and parental death and family conflicts; and, social factors such the possible influence of the media may also be involved in the production of foreign accents by patients.
文摘Objective: To observe the conversion disorder in a neurological emergency department. Methods: It is common that the initial approach to this patients include the use of various diagnostic exams. In this series we reviewed 94 patients that arrived a neurological emergency room in a 3 year period. Results: 72 patients were females (76%), and the initial presumptive diagnosis were: neurovascular syndrome in 36 patients (38.3%), convulsive disorder in 20 patients (21.28%), and conversive disorder in 8 patients (8.51%). 82 patients had motor symptoms and 61 sensitive symptoms. 88 patients (93%) required neuroimaging studies, 77 (81%) patients underwent through basic biochemical panels. Other tests performed were:electroencephalogram in 12 patients (12.77%), electromyography in 11 patients (11.7%), lumbar punction in 8 patients (8.04%) and regarding the medical consult in the care of these patients 11 were evaluated by 1 specialists, 35 (37.2%) by 2 different specialties, 42 (44.63%) patients required evaluation by 3, and 6 patients (6.38%) required evaluation by 4 different specialties. Conclusions: Based on this data, we conclude that conversion disorders require a lot of resources in the emergency room and that the similarities with neurological diseases demands a complete workup including expensive diagnostic tools. However, this patients can be discharged safely without requiring hospitalization.
文摘To facilitate gathering information during a psychiatric interview, some psychiatrists advocate augmenting the interview using drugs. Rather than barbiturates, benzodiazepines have been used for drug-assisted interviews. Dissociative amnesia is one of the indications for these interviews. Herein, we present the case of a 15-year-old female who was diagnosed as having dissociative amnesia because of conflicts with her friends. She was administered a Iorazepam-assisted interview to aid recovery of her memories. In this case, a small dose of Iorazepam was sufficient to recover her memories without any adverse effects.
基金supported by the CAS Knowledge Innovation Key Project (Grant No. KZCX2-YW- 330)the National Science Fund Fostering Talents in Basic Research to Glaciology and Geocryology (Grant No. J0630966)the Special Project Fund of State Key Laboratory of Engineering of Frozen Soil(Grant No. SKLFSE-ZQ-07)
文摘In order to study the nature of gas hydrate in porous media,the formation and dissociation processes of methane hydrate in loess were investigated.Five cooling rates were applied to form methane hydrate.The nucleation times of methane hydrate formation at each cooling rate were measured for comparison.The experimental results show that cooling rate is a significant factor affecting the nucleation of methane hydrate and gas conversion.Under the same initial conditions,the faster the cooling rate,the shorter the nucleation time,and the lower the methane gas conversion.Five dissociating temperatures were applied to conduct the dissociation experiment of methane hydrate formed in loess.The experimental results indicated that the temperature evidently controlled the dissociation of methane hydrate in loess and the higher the dissociating temperature,the faster the dissociating rates of methane hydrate.
文摘BACKGROUND Dissociation,which is defined as the failure to associate consciousness,memory,identity,emotion,perception,body representation,motor control,and behavior into an integrated whole,has long been assumed to be generated by trauma.If dissociation is a product of trauma exposure,then dissociation would be a major mental health outcome observed in studies of disaster survivors.Although some studies have examined dissociation in disasters,no systematic literature reviews have been conducted to date on the topic.AIM To systematically evaluate the literature on the association between disaster and dissociation to determine the prevalence and incidence of dissociation after exposure to disaster and further examine their relationship.METHODS EMBASE,Medline,and PsychINFO were searched from inception to January 1,2019 to identify studies examining dissociative disorders or symptoms related to a disaster in adult or child disaster survivors and disaster responders.Studies of military conflicts and war,articles not in English,and those with samples of 30 or more participants were excluded.Search terms used were“disaster*”and dissociation(“dissociat*,”“multiple personality,”“fugue,”“psychogenic amnesia,”“derealization,”and“depersonalization”).Reference lists of identified articles were scrutinized to identify studies for additional articles.RESULTS The final number of articles in the review was 53,including 36 articles with samples of adults aged 18 and above,5 of children/adolescents under age 18,and 12 of disaster workers.Included articles studied several types of disasters that occurred between 1989 and 2017,more than one-third(38%)from the United States.Only two studies had a primary aim to investigate dissociation in relation to disaster and none reported data on dissociative disorders.All of the studies used self-report symptom scales;none used structured interviews providing full diagnostic assessment of dissociative disorders or other psychopathology.Several studies mixed exposed and unexposed samples or did not differentiate outcomes between exposure groups.Studies examining associations between dissociation and disaster exposure have been inconclusive.The majority(75%)of the studies compared dissociation with posttraumatic stress,with inconsistent findings.Dissociation was found to be associated with a wide range of other psychiatric disorders,symptoms,and negative emotional,cognitive,and functional states.CONCLUSION The studies reviewed had serious methodological limitations including problems with measurement of psychopathology,sampling,and generation of unwarranted conclusions,precluding conclusions that dissociation is an established outcome of disaster.
