2nd February 2024

Dissociative Disorders

Diagnosis

This is the disruption in the normal integration of awareness, memory-recall and remembrance, identity, emotion, perception and insight, body representation, motor control and behaviour.

• Dissociative amnesia is the inability to recall important personal information, which is more than what could be explained by normal forgetfulness. The stress of remembering is even more traumatic.
• Localised amnesia is the most common and is the inability to recall a specific period of time or event, such as accidents or war incidents.
• Generalised amnesia is when an individual loses their entire identity and cannot remember their own life story. Sometimes, this can be as bad as losing or forgetting one’s own skills and talents.
• Selective amnesia is the inability to recall some parts of the traumatic incidents but not all.
• Continuous amnesia is when patients have no memory of events up to and including the present time.
• Systematised amnesia is where an individual loses memory for certain places or people.

Depersonalisation/ Derealisation

These are persistent or recurrent episodes of one or both depersonalisation and derealisation.

Depersonalisation is characterised by a feeling of unreality or detachment, or being an outside observer of one’s own thoughts, feelings, emotions, sensations, movements and actions. They might feel time sense distorted, numbed or even experience perceptual alterations.

Derealisation is when one experiences unreality or detachment from one’s surroundings. Surroundings are experienced as dream-like or foggy. 

Dissociative Identity Disorder

This was previously known as multiple personality disorder – with two or more personality traits in a single individual. In some cultures, it is known as possession. This disruption can alter their affect, behaviour, consciousness, memory, perception, cognition and or sensory-motor functioning. 

There can be difficulty in remembering everyday events. They cause distress and impact the patient’s day-to-day life.

These individuals report they suddenly become observers of their own speech and actions, and they even feel powerless about their situation. They may report multiple people or voices in themselves. They may report religious beings in their body. Sometimes, it could be a baby or a child versus an adult or older person.

References

• obo. (n.d.). Dissociative Disorders. [online] Available at: https://www.oxfordbibliographies.com/display/document/obo-9780199828340/obo-9780199828340-0164.xml#:~:text=Dissociative%20disorders%20are%20characterized%20by%20a%20disruption%20of [Accessed 24 Jan. 2023].
• Mitra, P. and Jain, A. (2021). Dissociative Identity Disorder. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK568768/
• Reinders, A.A.T.S. and Veltman, D.J. (2020). Dissociative identity disorder: out of the shadows at last? The British Journal of Psychiatry, [online] 219(2), pp.1–2. doi:10.1192/bjp.2020.168.
• www.uptodate.com. (n.d.). UpToDate. [online] Available at: http://www.uptodate.com/contents/dissociative-identity-disorder-epidemiology-pathogenesis-clinical-manifestations-course-assessment-and-diagnosis [Accessed 24 Jan. 2023].