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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.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 37 - 46
PubMed: 28946763

History

Received: 6 January 2017
Revision received: 22 April 2017
Revision received: 1 June 2017
Revision received: 19 June 2017
Accepted: 26 June 2017
Published online: 26 September 2017
Published in print: January 01, 2018

Keywords

  1. Dissociative Disorders
  2. Posttraumatic Stress Disorder
  3. Borderline Personality Disorder
  4. Meta-Analysis
  5. Dissociative Experience Scale

Authors

Details

Lisa Lyssenko, Dipl.-Psych. [email protected]
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.
Christian Schmahl, Dr.med.
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.
Laura Bockhacker, Dr.med.
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.
Ruben Vonderlin, M.Sc.
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.
Martin Bohus, Dr.med.
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.
Nikolaus Kleindienst, Dr.rer.hum.biol.
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.

Notes

Address correspondence to Ms. Lyssenko ([email protected]).

Author Contributions

The first two authors contributed equally.

Competing Interests

Dr. Schmahl has received advisory panel payments from Boehringer Ingelheim. The other authors report no financial relationships with commercial interests.

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