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Dissociative disorders in psychiatric inpatients

G N Saxe1, B A van der Kolk, R Berkowitz

  • 1Trauma Clinic, Harvard Medical School, Department of Psychiatry, Massachusetts Mental Health Center, Boston.

The American Journal of Psychiatry
|July 1, 1993
PubMed
Summary
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Fifteen percent of psychiatric inpatients have dissociative disorders, often linked to childhood trauma. These conditions and symptoms are frequently missed by clinicians, impacting patient care.

Area of Science:

  • Psychiatry
  • Psychology

Background:

  • Dissociative disorders are complex mental health conditions.
  • Childhood trauma is a known risk factor for developing dissociative disorders.
  • Recognition of dissociative symptoms in clinical settings can be challenging.

Purpose of the Study:

  • To determine the prevalence of dissociative disorders in psychiatric inpatients.
  • To assess the rate of childhood trauma in patients diagnosed with dissociative disorders.
  • To evaluate the recognition of dissociative experiences among psychiatric patients.

Main Methods:

  • 110 psychiatric inpatients were screened using the Dissociative Experiences Scale.
  • High-scoring patients were matched with low-scoring controls for further assessment.
  • Interviews included the Dissociative Disorders Interview Schedule, Traumatic Antecedent Questionnaire, and PTSD module; chart reviews were also performed.

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Main Results:

  • 15% of patients scored high on the Dissociative Experiences Scale, with 100% meeting criteria for a dissociative disorder.
  • Patients with dissociative disorders reported higher rates of childhood trauma, major depression, PTSD, substance abuse, and borderline personality disorder.
  • Chart reviews indicated that dissociative symptoms were largely unrecognized in clinical practice.

Conclusions:

  • A significant portion of psychiatric inpatients exhibit dissociative pathology.
  • Dissociative symptoms and disorders are often underrecognized by healthcare professionals.
  • Accurate diagnosis of dissociative disorders is crucial for improving patient outcomes.