Dissociative Disorder in the Iranian Culture: The Lawless Utopia

Epidemiologic and etiological studies of dissociative disorders are a challenging area in psychiatry. These challenges become more complex when noting that the existing theories cannot explain the differences observed in certain cases; for example, studies in Iran have reported the prevalence of dissociative disorders (dissociative amnesia, dissociative fugue, and depersonalization disorder) as less than 0.6%, and there has been no reported case of dissociative identity disorder (DID) in this country; meanwhile, the prevalence of all dissociative disorders in the general population of the US has been reported as 18.3%, and the prevalence of DID as about 1.1%. Although several studies indicate the high prevalence of dissociative symptoms in many Iranian psychiatric illnesses, dissociative disorders as a stand-alone disorder have a very low prevalence in Iran. The present article attempts to propose a possible hypothesis for the answer to the above questions through a different cultural conceptualization and seeks to be of some help to future studies in this area. Certainly, this hypothesis requires a careful study to be validated.