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Dissociative Disorders

Sundonia J. W. Wonnum, PhD, LCSW, Merima Bucaj, DO, FAAFP and Roselyn Jan W. Clemente-Fuentes, MD, FAAFP Reviewed 06/2019
 


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 su...

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.

PROGNOSIS

  • Ranges from spontaneous im...

REFERENCES

1
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

  • Brand B, Sar V, Stavropoulos P, et al. Separating fact from fiction: an empirical examination of six myths about dissociative identity disorder. Harv Rev Psychiatry.  2016;24(4...

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

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

  • Pay attention to diagnostic comorbidity and remember to treat these conditions as well.

  • Rule out the p...

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