Case Reports in PsychiatryVolume 20

Case Reports in Psychiatry
Volume 2014 (2014), Article ID 425892, 6 pages
http://dx.doi.org/10.1155/2014/425892
Case Report
Dissociative Disorders: Between Neurosis and Psychosis
C. Devillé, C. Moeglin, and O. Sentissi
Department of Mental Health and Psychiatry, General Psychiatry Department, University Hospital of Geneva, CAPPI Jonction, Rue des Bains 35, 1205 Geneva, Switzerland

Received 4 May 2014; Revised 17 August 2014; Accepted 15 September 2014; Published 22 October 2014

Academic Editor: Thomas Frodl

Copyright © 2014 C. Devillé et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Dissociative disorders are a set of disorders defined by a disturbance affecting functions that are normally integrated with a prevalence of 2.4 percent in industrialised countries. These disorders are often poorly diagnosed or misdiagnosed because of sharing common clinical features with psychotic disorders, but requiring a very different trajectory of care. Repeated clinical situations in a crisis centre in Geneva provided us with a critical overview of current evidence of knowledge in clinical and etiopathological field about dissociative disorders. Because of their multiple expressions and the overlap with psychotic disorders, we focused on the clinical aspects using three different situations to better understand their specificity and to extend our thinking to the relevance of terms “neurosis” and “psychosis.” Finally, we hope that this work might help physicians and psychiatrists to become more aware of this complex set of disorders while making a diagnosis.

1. Introduction

Dissociative disorders are a complex syndrome because of multiple expressions and the wide variety, defined by disturbances of every area of psychological functioning, affecting functions that are normally integrated such as memory, consciousness, identity, emotion, perception, body representation, motor control, and behaviour [1].

Major changes in dissociative disorders in the recent fifth edition of DSM-5 include the following: (1) derealization is included in the name and symptom structure of what previously was called depersonalization disorder (depersonalization-derealization disorder); (2) dissociative fugue is now a specifier of dissociative amnesia rather than a separate diagnosis; and (3) the criteria for dissociative identity disorder were changed to indicate that symptoms of disruption of identity may be reported as well as observed and that gaps in the recall of events may occur for everyday and not just traumatic events. Also, experiences of pathological possession in some cultures are included in the description of identity disruption.

According to ICD-10, there are more subtypes of diagnostic categories and depersonalization/derealization disorder is classified in neurotic disorders (see Table 1).

Hasil (Bahasa Indonesia) 1:

Laporan kasus psikiatriVolume 2014 (2014), artikel ID 425892, 6 Halamanhttp://DX.Doi.org/10.1155/2014/425892Laporan kasusDissociative Disorders: Antara Neurosis dan psikosisC. Devillé, C. Moeglin, dan O. SentissiDepartemen Kesehatan Mental dan psikiatri, Departemen Psikiatri umum, rumah sakit Universitas Jenewa, CAPPI Jonction, Rue des Bains 35, 1205 Jenewa, SwissMenerima 4 April 2014; Direvisi 17 Agustus 2014; Diterima 15 September 2014; Diterbitkan 22 Oktober 2014Editor akademik: Thomas FrodlHak cipta © 2014 C. Devillé et al. Ini adalah artikel akses terbuka yang didistribusikan di bawah lisensi Creative Commons atribusi, yang menggunakan izin tak dibatasi, distribusi, dan reproduksi dalam media apapun, disediakan karya asli benar dikutip.AbstrakDissociative disorders are a set of disorders defined by a disturbance affecting functions that are normally integrated with a prevalence of 2.4 percent in industrialised countries. These disorders are often poorly diagnosed or misdiagnosed because of sharing common clinical features with psychotic disorders, but requiring a very different trajectory of care. Repeated clinical situations in a crisis centre in Geneva provided us with a critical overview of current evidence of knowledge in clinical and etiopathological field about dissociative disorders. Because of their multiple expressions and the overlap with psychotic disorders, we focused on the clinical aspects using three different situations to better understand their specificity and to extend our thinking to the relevance of terms “neurosis” and “psychosis.” Finally, we hope that this work might help physicians and psychiatrists to become more aware of this complex set of disorders while making a diagnosis.1. IntroductionDissociative disorders are a complex syndrome because of multiple expressions and the wide variety, defined by disturbances of every area of psychological functioning, affecting functions that are normally integrated such as memory, consciousness, identity, emotion, perception, body representation, motor control, and behaviour [1].Major changes in dissociative disorders in the recent fifth edition of DSM-5 include the following: (1) derealization is included in the name and symptom structure of what previously was called depersonalization disorder (depersonalization-derealization disorder); (2) dissociative fugue is now a specifier of dissociative amnesia rather than a separate diagnosis; and (3) the criteria for dissociative identity disorder were changed to indicate that symptoms of disruption of identity may be reported as well as observed and that gaps in the recall of events may occur for everyday and not just traumatic events. Also, experiences of pathological possession in some cultures are included in the description of identity disruption.According to ICD-10, there are more subtypes of diagnostic categories and depersonalization/derealization disorder is classified in neurotic disorders (see Table 1).