Dissociative depression is associated with higher levels of disability than non-dissociative depression: An...

Dissociative depression has been increasingly recognized as a possible subtype of depression, which may explain some cases of treatment-resistant depression. Less is known about the prevalence of dissociative depression across cultures. In addition, no study has examined the relationship between dissociative depression and global disability, which reflects real-world functional impairments and social burden with significant public health implications. In this multi-site cross-sectional study, participants in Hong Kong (N = 999), Taiwan (N = 813), Malaysia (N = 421), and the Philippines (N = 1261) completed standardized, well-validated measures of depression, dissociation, and disability. Across the four samples, 32.1% to 62.9% of participants with depression presented with co-occurring clinically significant dissociative symptoms. One-way ANCOVA showed that participants with dissociative depression reported significantly higher levels of disability than participants with non-dissociative depression, controlling for demographic variables. The results are consistent and can be replicated across the four culturally different samples. While depression is a major public health concern, a considerable subgroup of people with depression may have co-occurring dissociation. This co-occurrence is associated with higher levels of impairments and requires additional clinical care and specific psychosocial interventions. Regular screening for dissociation should be conducted in individuals who present with depression.