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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.

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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.



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.


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


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).


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


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

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