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Am J Psychiatry. 2018 Jan 1;175(1):37-46. doi: 10.1176/appi.ajp.2017.17010025. Epub 2017 Sep 26.

Dissociation in Psychiatric Disorders: A Meta-Analysis of Studies Using the Dissociative Experiences Scale.

Author information

1
From the Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Germany; the Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; the Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario; and the Department of Health, Antwerp University, Antwerp, Belgium.

Abstract

OBJECTIVE:

Dissociation is a complex, ubiquitous construct in psychopathology. Symptoms of dissociation are present in a variety of mental disorders and have been connected to higher burden of illness and poorer treatment response, and not only in disorders with high levels of dissociation. This meta-analysis offers a systematic and evidence-based study of the prevalence and distribution of dissociation, as assessed by the Dissociative Experiences Scale, within different categories of mental disorders, and it updates an earlier meta-analysis.

METHOD:

More than 1,900 original publications were screened, and 216 were included in the meta-analysis, comprising 15,219 individuals in 19 diagnostic categories.

RESULTS:

The largest mean dissociation scores were found in dissociative disorders (mean scores >35), followed by posttraumatic stress disorder, borderline personality disorder, and conversion disorder (mean scores >25). Somatic symptom disorder, substance-related and addictive disorders, feeding and eating disorders, schizophrenia, anxiety disorder, OCD, and most affective disorders also showed mean dissociation scores >15. Bipolar disorders yielded the lowest dissociation scores (mean score, 14.8).

CONCLUSIONS:

The findings underline the importance of careful psychopathological assessment of dissociative symptoms in the entire range of mental disorders.

KEYWORDS:

Borderline Personality Disorder; Dissociative Disorders; Dissociative Experience Scale; Meta-Analysis; Posttraumatic Stress Disorder

Comment in

PMID:
28946763
DOI:
10.1176/appi.ajp.2017.17010025
[Indexed for MEDLINE]

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