Psychiatric Evaluation
We evaluated:
The presence of mental disorders using the mini international
neuropsychiatric interview (MINI) interview ver 5.0;
The presence of personality disorders using the structured clinical
interview for DSM-II (SCID-II) interview;
Psychopathologic characteristics and clinical severity using the
symptom checklist-90-revised (SCL-90-R) test and
The presence of dissociative phenomena with the DES.
We excluded:
Trauma/dissociative subtype of PTSD
Acute psychotic
Manic episode
A severe depressive episode
A stress-related disorder
A DD
Somatic symptom disorder.
Clinical Test Evaluation
The DES is a self-report instrument for rapid
compilation and processing that assesses the
presence, quantity and type of dissociative
experiences without considering specific diagnosis. It MINI is a semi-structured diagnostic
is composed of 28 items arranged on an analog assessment scale to identify the
scale. The cut-off value indicating the presence of DES pathologic psychiatric symptoms
pathologic dissociation regards scores $20: scores according to ICD-10 and DSM-IV. The
.20 are associated, in general, to a DD diagnosis. interview modules include 14 Axis I
disorders, 1 Axis II disorder
SCL-90 MINI
The SCL-90 is a self-
administered scale for the
evaluation of psychiatric The SCID-II is used to diagnose the personality disorders, both
symptomatology. It consists of in categorical terms (present or absent criteria) and
90 items representing nine
usually frequent clinical
SCIID-II quantitative terms. The SCID II consists of 119 items, with
dichotomous answers (Yes/No). A score of “3” on an item of
dimensions in outpatients the SCID-II, provided by the clinician, indicates that there is
sufficient evidence that the feature described by the item is
“pathologic”, “persistent” and “widespread”.
Collection and Analysis of Data
We evaluated the descriptive statistics of the data:
The distribution of dissociative symptoms seen with DES in
the sample
The frequency and type of diagnosed mental disorders
The frequency and type of personality disorders diagnosed
and sociodemographic characteristics of the subjects.
Statistical methods
ANOVA
T-Test
Spearman
ANOVA
Regresi Logistik
RESULT
Total sample 933 subjects
118 713
no mental Mental
disorder disorder
296
Personality
disorder
So, young age seems to be associated with more severe dissociative symptoms
except for amnesic symptoms.
All scores significantly higher amongunmarried or celibate participants
10% 50% 100% 90%
Dissociative symptoms were significantly
more severe in the first group than the second group
This psychopathologic traits
detected with SCL-90-R if
signifficant total score on DES
scale correlated with Spearmen,
and results are : • Maximum
• Minimum
Significantly on :
Subjects affected by major depressive disorder or hypomanic disorder,
patients under pharmacologic treatment, patients affected by generalized
anxiety disorder or psychotic disorders presented average total DES
scores higher than controls (p <0.001)
DISCUSSION
- Symptoms of DD are suggested as generated by the psychic
mechanism of “separation”
- Amnestic symptoms generated by the
compartmentalization of painful memory contents, are
unanimously considered typical pathologic manifestations
related to trauma more serious than other dissociative
events.
- Absorption and depersonalization symptoms are linked to the
semi-physiologic nature of the detachment mechanism itself
The positive result of the univariate ANOVA for these two personality disorders (but not
for the other personality disorders) suggests the existence of a specific link between these
disorders of personality and DDs.
- Individuals affected by borderline personality - the narcissist hypervigilant try to maintain their
disorder, reports of traumatic events or of long self-esteem by preventing situations of
periods of overwhelming stress are common. vulnerability
- experiences difficulties in integrating positive
and negative views of self and others by creating
a division between segregated positive and
negative feelings.
- According to psychodynamic vision, the obsessiveness is based on the “separation of
affections” defense mechanism, which can be considered as an emotional
desensitization mechanism.
- Patients defend themselves from these feelings through reactive formation and isolation
of affection, as they find rage and addiction as consciously inacceptable concepts
- Psychotic disorders are considered as:
a disorder of the self,
deficit in awareness of somatosensory experiences,
these processes may involve the same frontal neural network able to disconnect
experiences, feeling and consciousness in dissociative phenomena
(b) For the matched studies, give matching criteria and number of
exposed and exposed NO
7. Clearly define all outcomes, exposures, predictors, potential confounders,
and effect modifiers. Give diagnostic criteria, if applicable YES
8. For each variable of interest, give sources of data and details of methods of
assessment (measurement). Describe comparability of assessment
methods if there is more than one group YES
9. Describe any efforts to address potential sources of bias NO
10. Explain how the study size was arrived at NO
11. Explain how quantitative variables were handled in the analyses. If
applicable, describe which groupings were chosen and why NO
12 (a) Describe all statistical methods, including those used to control for
confounding YES
(b) Describe any methods used to examine subgroups and interactions YES
22. Give the source of funding and the role of the funders for the present
study and, if applicable, for the original study on which the present article
is based NO
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