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Dissociative Disorders

Moshe S. Torem, MD, DLFAPA Reviewed 06/2018
 


BASICS

DESCRIPTION

  • According to Diagnostic and Statistical Manual of Mental Disorders (DSM-5), dissociative disorders are manifested by a disruption in the continuity of normal integration of conscious...

DIAGNOSIS

HISTORY

  • All disorders share symptoms that

    • Cause significant distress or impairment in social, occupational, or other areas of functioning

    • Are not due to the direct physiologic effects of a subs...

TREATMENT

GENERAL MEASURES

  • Individual psychotherapy plus behavior modification and, in selective cases, hypnotherapy (4)[A]

  • Adjuncts: group therapy, expressive art therapy, occupational and recreational...

ONGOING CARE

PATIENT EDUCATION

  • Self-hypnosis, relaxation exercises, guided imagery, mindfulness meditation

  • Encourage patients to become educated about their condition and be inspired by those who got be...

REFERENCES

American Psychiatric Association. Dissociative disorders. In: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013:291–307.
...

ADDITIONAL READING

  • Bob P, Svetlak M. Dissociative states and neural complexity. Brain Cogn.  2011;75(2):188–195.

  • Brand B, Loewenstein RJ. Dissociative disorders and overview of assessment, phenome...

CODES

ICD10

  • F44.9 Dissociative and conversion disorder, unspecified

  • F44.0 Dissociative amnesia

  • F44.1 Dissociative fugue

  • F44.81 Dissociative identity disorder

  • F44.89 Other dissociative and conversion disord...

CLINICAL PEARLS

  • Focus on improving and maintaining adaptive functioning with ADLs.

  • Symptom stabilization and ego strengthening come before exploration of past trauma.

  • Pay attention to diagnostic comorbi...

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