Stress response in dissociation and conversion disorders: A systematic review.

Area of Science:

• Neuroscience
• Psychiatry
• Endocrinology

Background:

• Dissociative disorders (DD) and conversion disorders (CD) are prevalent in general and psychiatric populations.
• Evidence suggests dysregulation of the hypothalamic-pituitary axis (HPA) and autonomic nervous system (ANS) in these disorders.

Purpose of the Study:

• To systematically review and summarize current knowledge on the stress response (HPA and/or ANS) in patients with DD, CD, or dissociative symptoms.
• To understand the association between stress response alterations and the emergence/persistence of DD and CD.

Main Methods:

• Systematic literature search of Medline and Web of Science.
• Used Medical Subject Headings related to stress axis, CD, DD, and dissociative symptoms.
• Adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Main Results:

• In individuals without psychiatric history, higher cortisol secretion correlated with higher dissociation scores.
• The stress system may be blunted in post-traumatic stress disorder patients experiencing dissociative symptoms.
• Altered stress responses are associated with the onset and continuation of DD and CD.

Conclusions:

• Stress response monitoring and detailed stress exposure history are crucial for understanding DD and CD.
• Further larger studies are recommended to investigate these associations.
• Findings highlight the neurobiological underpinnings of dissociative and conversion disorders.