The key finding of dissociative amnesia is the patient's inability to recall specific autobiographical details that are connected with severe stress episodes. Dissociative amnesia causes significant social distress and reduces the quality of life. Amnesia is usually selective but can span several years up to decades depending on the persistence of the traumatic situation. The stronger the stress, the more pronounced the memory loss [1] [2]. Patients avoid eye contact, show normal activity levels but are aware of their memory loss which may lead to profound frustration. Orientation is normal but anxiety and lack of attentiveness are frequently encountered. Dissociative fugue is a subtype of dissociative amnesia which is characterized by a sudden intentional traveling urge accompanied by dissociative amnesia. Dissociative fugue occurs most often among sexual abuse victims [3] [4] [5]. Dissociative amnesia can be reversible [6].

Cases with dissociative identity disorder are easily irritable and anxious while avoiding eye contact; orientation, long- and short-term memory are often impaired. The characteristic finding of dissociative identity disorder, however, is the existence of at least one additional distinct personalities in one patient. These alter egos can differ significantly from the original character in psychological complexity, body posture, language and even sex. Dissociative identity disorder is almost always accompanied by dissociative amnesia and occurs most frequently in victims of child abuse [3] [7].

Dissociative derealization has also been associated with childhood trauma and stress situations, in particular long-term emotional maltreatment. Patients experience a surreal detachment of their environment and themselves. Their perception of reality is either blurred or unusually sharp, dull and sometimes systematically distorted. Such patients have the tendency to 'remote-control' other people [8].

Patients with the atypical dissociative disorder can present with abnormal dialogue behavior, impaired vigilance or hallucinations. It primarily affects men.

• Aspiration

  Treatment for DID is based on your personal needs and aspirations. It can take time working with a specialist in DID care to make progress and help you achieve your goals, but you can achieve significant progress in taking control of your life. [mentalhealth.org.nz]

• Fracture

  For those that would like to integrate, therapists can help them recognize each personality as a fractured part of themselves that should be embraced rather than eliminated. [goodencenter.org]

• Compulsive Disorder

  […] with obsessive-compulsive disorder (OCD). [ncbi.nlm.nih.gov]

  The author will present and examine five neurotic cases with auditory hallucinations, including obsessive-compulsive disorder, post-traumatic stress disorder, borderline personality disorder, dissociative identity disorder, and dissociative disorder not [ci.nii.ac.jp]

  Additionally, if dissociative disorder is a symptom of another disorder, such as post traumatic stress disorder, panic disorder, or obsessive compulsive disorder, you may qualify for benefits under those disorders. [disabilitysecrets.com]

  Obsessive-Compulsive Disorder This anxiety disorder is characterized by intrusive thoughts (obsessions), by repetitive behaviors (compulsions), or both. Obsessions produce uneasiness, fear, or worry. [nobaproject.com]

  […] phobias an eating disorder obsessive-compulsive disorder They may also have problems sleeping (insomnia). [theburydirectory.co.uk]

• Self-Mutilation

  Common forms of self-injurious behaviors include cutting... Read More A study was published this June 2006 that reported that one in five students at two Ivy League universities engaged in self mutilation. The study pointed out that the problem... [mentalhelp.net]

  According to the Mayo Clinic, individuals who suffer from these conditions may also develop sleep disorders, anxiety, eating disorders, headaches, sexual addiction or related issues, cutting (self-mutilating), and may even attempt suicide. [axisresidentialtreatment.com]

  According to the Mayo Clinic, adults with dissociative disorders face a high risk of: Suicide Self-mutilation, such as cutting or burning their skin Drug and alcohol abuse Eating disorders Severe headaches Children may also face these risks, but they [luxury.rehabs.com]

• Self-Mutilation

  Common forms of self-injurious behaviors include cutting... Read More A study was published this June 2006 that reported that one in five students at two Ivy League universities engaged in self mutilation. The study pointed out that the problem... [mentalhelp.net]

  According to the Mayo Clinic, individuals who suffer from these conditions may also develop sleep disorders, anxiety, eating disorders, headaches, sexual addiction or related issues, cutting (self-mutilating), and may even attempt suicide. [axisresidentialtreatment.com]

  According to the Mayo Clinic, adults with dissociative disorders face a high risk of: Suicide Self-mutilation, such as cutting or burning their skin Drug and alcohol abuse Eating disorders Severe headaches Children may also face these risks, but they [luxury.rehabs.com]

• Disorganized Behavior

  Disorganized mental processes in mothers, frightening/frightened caregiving, and disoriented/disorganized behavior in infancy. [doi.org]

  Symptoms of Schizophrenia The main symptoms of schizophrenia include hallucinations, delusions, disorganized thinking, disorganized or abnormal motor behavior, and negative symptoms (APA, 2013). [courses.lumenlearning.com]

• Seizure

  He then highlights the distinctions among MPD, schizophrenia, borderline personality disorder, major depression, and complex partial seizures. [ncbi.nlm.nih.gov]

  Dissociative seizures also known as psychogenic non-epileptic seizures: seizures that are often mistaken for epilepsy but are not caused by electrical pulses in the brain and are in fact another form of dissociation. [en.wikipedia.org]

  Depersonalization or derealization can also occur as a symptom in many other mental disorders as well as in physical disorders such as seizure disorders (ictal or postictal). [msdmanuals.com]

  Depersonalization and/or derealization also might be symptoms of other disorders, including brain diseases and seizure disorders. Depersonalization/derealization disorder is one of a group of conditions called dissociative disorders. [my.clevelandclinic.org]

  The disturbance is not attributable to the physiological effects of a substance (eg, a drug of abuse, medication) or other medical condition (eg, seizures). [information.pods-online.org.uk]

• Insomnia

  Many signs and symptoms identified during routine mental health assessments (e.g. depression, anxiety, insomnia, self-harming, hearing voices) are common to other mental health problems more familiar to the clinician. [mindjersey.org]

  How the doctor determines if you have DID (diagnosis) DID can be difficult to diagnose as any signs and symptoms identified during routine mental health assessments (eg, for depression, anxiety, insomnia, self-harming, hearing voices) are common to other [mentalhealth.org.nz]

  such as: medically unexplained symptoms post-traumatic stress disorder depression mood swings anxiety and panic attacks suicidal tendencies or self-harm phobias an eating disorder obsessive-compulsive disorder They may also have problems sleeping (insomnia [theburydirectory.co.uk]

  such as: medically unexplained symptoms post-traumatic stress disorder depression mood swings anxiety and panic attacks suicidal tendencies or self-harm phobias an eating disorder obsessive compulsive disorder They may also have problems sleeping (insomnia [nhs.uk]

  Complications Without treatment, possible complications for a person with a dissociative disorder may include: Life difficulties such as broken relationships and job loss Sleep problems such as insomnia Sexual problems Severe depression Anxiety disorders [betterhealth.vic.gov.au]

• Memory Impairment

  Inter-identity amnesia in dissociative identity disorder: A simulated memory impairment? Psychological Medicine, 36, 857 – 863. Google Scholar | Crossref | Medline Kihlstrom, J. F. ( 2005 ). Dissociative disorders. [doi.org]

  The memory impairments are not caused by ordinary forgetting. [courses.lumenlearning.com]

  The sufferer therefore experiences significant memory impairment for important information not explained by ordinary forgetfulness. [nobaproject.com]

Diagnosis of dissociative disorders rests on an analysis of the patient history, clinical criteria and the exclusion of potential causes like substance abuse.

The main criterion for the diagnosis of dissociative amnesia is the trauma-related inability of a victim to recall important personal information causing substantial social distress. Dissociative identity disorder is characterized by the existence of alter egos in addition to dissociative amnesia. A key symptom of dissociative depersonalization is a distorted perception of reality and self [7].

Psychiatric examinations will reveal these features. Family history analysis should focus on traumatic events like abuse during childhood. Further exams should corroborate the diagnosis by excluding organic causative factors. Electroencephalography (EEG) and magnetic resonance imaging (MRI) procedures can help to rule out physical causes. Substance abuse (e.g. cannabis) can be proven with urinalysis [8].

Abstract Although treatment outcome research on dissociative disorders (DD) is increasing, an examination of treatment progress in young adults with these disorders remains noticeably absent from the literature. [ncbi.nlm.nih.gov]

The latest research indicates that DD patients show a suboptimal response to standard exposure-based treatments for posttraumatic stress disorder as well as high levels of attrition from treatment. [doi.org]

Phase-orientated treatment has been shown to improve dissociative identity disorder. [theconversation.com]

Prognosis of Dissociative Disorders The prognosis of dissociative disorders varies by type. Dissociative amnesia and dissociative fugue have a good prognosis, resolving spontaenously and recurring rarely. [myvmc.com]

[…] recall past and loss of identity associated with traumatic circumstances ( e.g., disaster and war) and acute life stress leads to significant distress or impairment not the result of substance abuse or general medical condition Treatment psychotherapy Prognosis [step2.medbullets.com]

A better prognosis was found in dissociative disorder children and adolescents with younger age at first presentation [ 24 ]. [doi.org]

Treatment and Prognosis of Dissociative Disorders Dissociative disorders rarely resolve on their own, and professional treatment is required. [bridgestorecovery.com]

Prognosis Prognoses for dissociative disorders vary. Recovery from dissociative fugue is usually rapid. Dissociative amnesia may resolve quickly, but can become a chronic disorder in some patients. [medical-dictionary.thefreedictionary.com]

This article presents a summary of the BASK model of dissociation and two other models and gives ideas on how these models may be applied to the understanding of the etiology of dissociative disorders and their treatment. [ncbi.nlm.nih.gov]

Etiology of Dissociative Disorders Many researchers believe that severe stress plays a role in the onset of dissociative disorders. However, they cannot explain why only a small minority of people who experience severe stress develop such disorders. [sparknotes.com]

The purpose of this article is to review the published cases of childhood DID in order to evaluate its scientific status, and to answer research questions related to the etiological models. [doi.org]

Even the claimed etiological link between trauma/abuse and dissociation has been questioned. [en.wikipedia.org]

This article reviews the epidemiology and clinical symptomatology of these disorders. In addition, various screening and diagnostic instruments, such as the DES, Structured Clinical Interview for Dissociative Disorders, and MMPI, are discussed. [ncbi.nlm.nih.gov]

Psychiatry, The American Psychiatric Publishing Textbook of Neuropsychiatry and Behavioral Neurosciences, and their Essentials editions, the guide first takes readers through the basic sciences that undergird the discipline (e.g., neuroanatomy, genetics, and epidemiology [books.google.com]

Ross CA: Epidemiology of multiple personality disorder and dissociation. Psychiatr Clin North Am 1991;14:503–517. Ross CA: Epidemiology of dissociation in children and adolescents. Child Adolesc Psychiatr Clin N Am 1996;5:273–284. [doi.org]

Social Psychiatry and Psychiatric Epidemiology, (in press). Levin, R., & Fireman, G. (2002). Nightmare prevalence, nightmare distress, and self-reported psychological disturbance. Sleep, 25, 205–212. Levitan, H. L. (1967). [nobaproject.com]

Persistent elevations of cerebrospinal fluid concentrations of corticotropin-releasing factor in adult nonhuman primates exposed to early-life stressors: Implications for the pathophysiology of mood and anxiety disorders. [doi.org]

The neurobiological approach Neuroimaging techniques have contributed to the understanding of the basic mechanisms of conversion and dissociative disorders and on some points, pathophysiological equivalents exist for the psychological theories mentioned [cochranelibrary.com]

Future research should not only address treatment outcomes, but also focus on public policy around prevention and detection of extreme trauma. [theconversation.com]

These findings point to dissociation and depression severity as important correlates of NSSI and suicidality in patients with dissociative disorders and have implications for self-harm prevention and treatment. [ncbi.nlm.nih.gov]

[…] and loss of identity associated with traumatic circumstances ( e.g., disaster and war) and acute life stress leads to significant distress or impairment not the result of substance abuse or general medical condition Treatment psychotherapy Prognosis, Prevention [step2.medbullets.com]

Prevention Since the primary cause of dissociative disorders is thought to involve extended periods of humanly inflicted trauma, prevention depends on the elimination of child abuse and psychological abuse of adult prisoners or hostages. [medical-dictionary.thefreedictionary.com]

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