1. DISSOCIATIVE
DISORDERS
-DR.
DEEPIKA SINGH
-JR1, DEPT OF PSYCHIATRY,
-GSMC & KEMH

2. Dissociation:

“Disruption in the integrated
functions of
consciousness
 memory
 identity
 perception of the environment”
(DSM-IV)


3. HISTORY

4. EPIDEMIOLOGY:
Dissociative & conversion disorder
constitutes 7.3 to 13% of all
psychiatric cases.
Conversion > dissociation
Women > men

5. CLASSIFICATION






DSM IV TR includes:
Dissociative amnesia
Dissociative fugue
Dissociative identity disorder
Depersonalization disorder
Dissociative disorder NOS

6. ICD 10 Classification includes:
1. DISSOCIATIVE AMNESIA
2. DISSOCIATIVE FUGUE
3. DISSOCIATIVE STUPOR
4. DISSOCIATIVE TRANCE &
POSSESSION
5. DISSOCIATIVE D/Os OF
MOVEMENT & SENSATION
6. OTHER DISSOCIATIVE D/Os

7. Conversion disorder
In ICD 10 it is further classified as:
1) Dissociative motor disorder
2) Dissociative anesthesia &
sensory loss
3) Dissociative convulsions

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10. SSSS
DISSOCIATIVE DISORDER

11. Dissociative Amnesia DSM IV



1 or more episodes of inability to recall
important personal information (traumatic
or stressful, that is too extensive to be
explained by ordinary forgetfulness)
Disturbance does not occur during any
other dissociative d/o & not due to direct
effects of a substance or GMC
Symptoms cause clinically significant
distress or impaired social or
occupational ,etc functioning

12. sssssssssssssssssss

13. 
Types of amnesia:
Localized amnesia
 Selective/ Systematized amnesia
 Generalized amnesia
 Continuous amnesia


14. Dissociative fugue

Amnesia plus flight


Latin fugere, “to flee”
Sudden, unexpected travel with
inability to recall one’s past

Assume new identity

May involve new
name, job, personality characteristics
More often of brief duration
 Remits spontaneously


16. Dissociative Fugue DSM IV




Sudden unexpected travel away
from home or ones customary place
of work, with inability to recall one’s
past.
Confusion about personal identity or
assumes new identity (partial or
complete)
Not due to another dd d/o or direct
effects of substances or GMC
Causes significant distress or
impairment in imp areas of
functioning

17. Dissociative identity disorder

DSM-IV-TR criteria
 Presence of two or more
personalities (alters)
 At least two of the alters
recurrently take control of
behavior
 Inability of at least one of the
alters to recall important personal
information

18. END

19. 


Epidemiology
 No identified reports of DID or
dissociative amnesia before 1800
(Pope et al., 2006).
 Major increases in rates since 1970s
DSM-III (1980)
 Diagnostic criteria more explicit
Appearance of DID in popular culture
 Sybil, 1973
 Book and movie received much
attention

20. Trance & possesion d/o

21. Dissociative stupor

It is characterised by
an absence or
marked dimunition of
voluntary movements
& speech in the
presence of normal
or relatively
preserved conscious
awareness.

22. Depersonalization




A. Persistent or recurrent experiences of
feeling detached from & as if one is an
outside observer of, one’s mental
processes or body (e.g. like feeling like one
is in a dream)
B. During the episode, reality testing
remains intact
C. Causes significant distress or
impairment in social, occupational
functioning
D. Not due to another mental
d/o, ,dissociative d/o, substances or GMC
(temp lobe epilepsy)

24. Dissociaive d/o nos


Dissociative symptoms are
predominant, but the clinical picture
does not meet full criteria for a
dissociative d/o
1. Ganser’s syndrome; Prisoners
with personality d/os giving
approximate answers to questionseg. 2+2=5 or talking past the point
usually with other symptoms like
amnesia, perceptual disturbances .

25. Dissociative d/o nos



Mass hysteria
Combat hysteria
Dissociative trance d/o-in certain
cultures

26. References

27. References



1. CTP
2. SYNOPSIS OF
PSYCHIATRY
3. NEERAJ AHUJA PG
TEXTBOOK OF PSYCHIATRY