Dissociative (conversion) disorders are the psyche's response to experiencing heavy events - mental disorders or somatic symptoms appearing in their course (eg sensory disturbances or paresis) are supposed to "distract" the mind from unresolved emotional conflicts. Read the causes and types of dissociative disorders, find out how they are diagnosed and their symptoms, and learn about treatment for conversion disorders.

Contents:

  1. Dissociative disorders: what are they?
  2. Dissociative disorders: causes
  3. Dissociative disorders: types
  4. Dissociative Disorders: Treatment

Dissociative disorders: what are they?

Dissociative (conversion) disorder is unknown to many people, but actually quite an interesting term. The word dissociation comes from the Latin "dissociatio", which means separation - in the case of psychiatry this term is used to describe the separation of what is closely related on a daily basis: awareness, memory and feeling various stimuli. Conversion, on the other hand, is defined differently. According to one of the medical classifications of diseases - ICD-10 - conversion is synonymous with dissociation.

Another classification, which is the American DSM, separates both phenomena from each other and defines various somatic symptoms as conversion, e.g. neurological - which appear in people due to the existence of various unresolved mental conflicts.

Episodes of dissociation are experienced by every person in their lives - they are even moments when we awake to various dreams and temporarily lose the sense of contact with reality. Such states are absolutely no problem and don't have to be alarming.

The situation is definitely different when the patient develops some dissociative (conversion) disorders - in such a situation it is absolutely necessary to take a closer look at the patient's condition. Problems included in this group may occur at any age, but they typically develop in adolescents and young adults.

They are definitely more common in women than in men. The frequency of dissociative disorders is assessed differently, she estimatesfrom 11 to 300 out of 100,000 people may suffer from them.

Adaptation disorders: causes, symptoms, treatment

Reactive Disorders: How to Recognize Them?

Nervous breakdown: causes, symptoms, treatment

Dissociative disorders: causes

Dissociative disorders may develop in connection with a difficult experience, extremely stressful situations, both in the past (e.g. in childhood), and they may appear in response to a recently experienced trauma.

Dissociation aims to distract you from thinking about very unpleasant memories.

Examples of events that may be the causes of dissociative disorders include:

  • rape,
  • sexual harassment,
  • experiencing aggression from relatives (both physically and mentally),
  • bullying by peers,
  • natural disaster,
  • car accident,
  • war.

Various problems occurring in patients may predispose to dissociative disorders. These include, first of all, substance abuse, depressive disorders, personality disorders (especially borderline personality and histrionic personality disorders) as well as various damage to the structures of the central nervous system and post-traumatic stress disorder.

Dissociative disorders: types

There is not much talk about conversion disorders, and in fact there are many problems included in this group. These disorders can manifest themselves in a variety of ways - a symptom of dissociative disorders can be both a sudden loss of memory related to certain specific events, and the occurrence of atypical seizures resembling convulsive or specific, even strange localization, sensory disturbances.

1. Dissociative amnesia

A characteristic feature of this problem is that amnesia usually concerns a strictly defined period of time - typically the patient does not remember the traumatic event. In the case of this dissociative disorder, the fact that the patient with it does not experience any difficulties with remembering new information is noteworthy.

2. Dissociative fugue

Fugue is quite an intriguing dissociative disorder - in her case, the patient travels to different places (usually places that evoke significant emotions in him), which later … he does not remember. During these journeys, a person can assume a completely different identity.

3. Trance and possession

Patientbeing in a trance, he has no control over his body or thinking, he also has no ability to experience himself or feel one with his own identity - however, it can be replaced by some external identity.

In the case of possession, the patient's personality is replaced with a completely different one (usually demonic), which may be accompanied by speaking in a foreign voice or in a completely foreign language.

It should be emphasized here that trance and possession are classified as mental disorders only when they occur against the will of a given person (when these phenomena occur, e.g. in connection with some religious rituals, then they are no longer considered as dissociative disorders).

Amnesia, or severe memory impairment

Quantitative and Qualitative Disorders of Consciousness

Somatomorphic disorders: causes, symptoms, treatment

4. Dissociative movement disorder

This type of dissociative disorders may manifest itself in, for example, paresis or complete paralysis of certain parts of the body (e.g. lower limbs), in addition, patients may also experience various additional movements (they may resemble involuntary movements known to medics, usually however, they do not fully meet the criteria for recognizing each of them).

Dissociative movement disorders may also cause abnormalities related to the work of facial muscles or the work of muscles belonging to the speech apparatus (in such a situation, the patient may experience various speech disorders).

5. Dissociative seizures

The problem is also referred to as psychogenic pseudo-epileptic seizures. In its course, the patient experiences disorders that resemble an epileptic seizure, but in reality, apart from these problems, there are no other symptoms that are associated with epilepsy.

It is also characteristic that - unlike in an epileptic seizure - the patient does not lose consciousness (during a psychogenic seizure, the patient's awareness is fully or partially preserved).

6. Dissociative stupor

A patient in a state of dissociative stupor (or dissociative stupor) is cut off from the world - he does not communicate with others, does not speak, does not eat, he may also not move. At the same time, during this dissociative disorder, the patient's awareness is usually fully preserved.

7. Dissociative anesthesia and loss of sensory sensation

A type of dissociative disorder whose symptoms revolve around the sensory organs.The patient may report desensitization in certain areas of the body (e.g., report that the problem is in the lower limbs). There may be visual disturbances - they may include both a decrease in acuity or a reduced range of vision, but also sudden, complete blindness. Hearing disorders, including sudden deafness, may also appear.

8. Other dissociative disorders

The next units that belong to the dissociative disorders are the plural personality (split personality) and the Ganser syndrome. The multiple personality problem is quite an interesting problem - it comes to the fact that the patient has two (or more) completely different personalities. None of the patient's personalities knows about the existence of others, what's more - these personalities may differ in age, gender or even intellectual level.

Ganser's syndrome is a disorder that is quite difficult to distinguish from simulation. Well, it consists in the fact that in a conversation the patient - even one whose intellect seems definitely not deviating from the norm - can answer absurdly to simple questions asked to him. Such a question may be a question about the sum of the numbers 1 and 2, where a patient with Ganser syndrome will answer "four" or a question what time of the year follows winter - a person with this disorder may answer "fall".

In the case of this dissociative disorder, the patient may also use everyday utensils extremely incorrectly, e.g. try to eat food with the reverse side of the fork.

Dissociative Disorder: Recognition

It's definitely not easy to get a diagnosis of conversion disorders. Usually, the patient goes to specialists other than a psychiatrist - for example, a person with visual impairment visits an ophthalmologist, and in the case of sensory disturbances or seizures resembling convulsive seizures, the patient may refer to a neurologist.

Basically, this is not an incorrect procedure - before making a diagnosis of dissociative disorders, it is necessary to exclude organic reasons for the patient's symptoms (and such, especially in the case of neurological symptoms, theoretically could even be such serious diseases as stroke or brain tumor).

When a patient suffers from dissociative disorders, no deviations are detected in the various tests performed on him. It can be disturbing both in the patient and in the doctor - the former would like to finally know what is wrong with him, the latter may feel completely powerless, or vice versa - irritated by the feeling that the visitor is simply simulating him.

In the case of conversion disorders, definitely yesit is not - patients with them do not use simulations, but their psyche, in a way, generates various symptoms in order to suppress heavy emotions. Mental he alth specialists - psychiatrists and psychologists - are the right specialists who should be referred to by people with suspected conversion disorders.

Dissociative Disorders: Treatment

Dissociative disorders may resolve spontaneously after some time, but this may not be the case in all patients. If the unusual symptoms persist for a long time, it is definitely necessary to start therapy.

In the treatment of dissociative disorders, it is necessary to work through unresolved emotional conflicts from which the patient "runs away" - psychotherapy is used for this purpose. It aims, inter alia, to making the patient understand what exactly the situation is responsible for the appearance of his ailments. People with dissociative disorders are sometimes recommended various types of psychotherapy, quite often in the case of this problem, cognitive-behavioral therapy is used. Psychotherapy is the basis for the treatment of dissociative disorders, but in some cases - e.g. in the presence of severe anxiety symptoms in a patient - it may be advisable to add pharmacological treatment based on the use of anxiolytic drugs.

Worth knowing

Dissociative disorders: prognosis

The prognosis of most people suffering from dissociative disorders is good - the majority of patients manage to regress these disorders. Worse effects of therapy are achieved when the patient's conversion disorders persist for a long time, when he is additionally burdened with other mental disorders (especially personality disorders) and when the patient shows low motivation to participate in psychotherapy.

Sources:

1. "Psychiatria", scientific editor M. Jarema, J. Rabe-Jabłońska, ed. PZWL, Warsaw 2011

2. "Psychiatry. A textbook for students", B. K. Puri, I. H. Treasaden, eds. I Polish J. Rybakowski, F. Rybakowski, Elsevier Urban & Partner, Wrocław 2014

3. Deville C. et al., Dissociative Disorders: Between Neurosis and Psychosis, Case Rep Psychiatry. 2014; 2014: 425892

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, focusing on always listening to them and spending as much time as possible.they need.

Category:

Psychiatry