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Epidemiology of Dissociative Disorders: An Overview

DOI: 10.1155/2011/404538

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General psychiatric assessment instruments do not cover DSM-IV dissociative disorders. Many large-scale epidemiological studies led to biased results due to this deficit in their methodology. Nevertheless, screening studies using diagnostic tools designed to assess dissociative disorders yielded lifetime prevalence rates around 10% in clinical populations and in the community. Special populations such as psychiatric emergency ward applicants, drug addicts, and women in prostitution demonstrated the highest rates. Data derived from epidemiological studies also support clinical findings about the relationship between childhood adverse experiences and dissociative disorders. Thus, dissociative disorders constitute a hidden and neglected public health problem. Better and early recognition of dissociative disorders would increase awareness about childhood traumata in the community and support prevention of them alongside their clinical consequences. 1. Introduction Dissociation is defined as a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment [1]. Dissociative disorders constitute a group of clinical syndromes covering disturbances attributed to one or more of these domains. Dissociation may be sudden or gradual, transient, or chronic. Being the most chronic and complex type of dissociative disorders, dissociative identity disorder (DID) constitutes an overarching syndrome covering all dissociative phenomena. Depersonalization disorder, dissociative amnesia, and dissociative fugue are further categories of dissociative disorders. Dissociative conditions which do not fit diagnostic criteria of these specific categories are diagnosed as having dissociative disorder not otherwise specified (DDNOS). Although not specified as such in official classification systems, the concept of chronic complex dissociative disorder deserves a rather detailed description here, because it is a significant category for epidemiological studies in particular. Due to the tight definition of DID in DSM-IV [1], a larger group of subjects who are close to DID in their symptomatology are being diagnosed as having the type-1 of the dissociative disorder not otherwise specified (DDNOS-1). The latter group is consisted of the subjects who have identity alteration without dissociative amnesia or whose identity alteration is too mild to fit the diagnostic criterion of DID. In fact, the difference between two categories is a matter of severity but not a qualitative one. Thus, DID and DDNOS-1 constitute the chronic complex

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