Psychiatry and Clinical Neurosciences 2015; 69: 369–374
doi:10.1111/pcn.12256
Regular Article
High psychiatric comorbidity in adolescents with dissociative disorders Hasan Bozkurt, MD,1* Tuba Duzman Mutluer, Salih Zoroglu, MD2
MD,2
Cigdem Kose,
PhD2
and
1
Department of Child and Adolescent Psychiatry, Faculty of Medicine, Gaziosmanpasa University, Tokat, and 2Department of Child and Adolescent Psychiatry, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
Aim: The aim of this study was to evaluate psychiatric comorbidity rates and patterns in a sample of clinically referred adolescents diagnosed with dissociative disorders (DD) by using a structured interview. Methods: All participants completed a comprehensive test battery, which consisted of a questionnaire for sociodemographic data and clinical history, Child Posttraumatic Stress Reaction Index, Childhood Abuse and Neglect Questionnaire and the Adolescent Dissociative Experiences Scale. Diagnosis was made by the Structured Clinical Interview for DSM-IV Dissociative Disorders. Psychiatric comorbidity was assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children – Present and Lifetime Version. Results: A total of 25 adolescent subjects aged 12–18 years participated in the study. Ten adolescents were diagnosed as having dissociative identity disorder and 15 of them were diagnosed as having dissociative disorder–not otherwise specified based on the Struc-
ISSOCIATIVE DISORDERS (DD) are characterized by a disruption and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior. Dissociative symptoms
D
*Correspondence: Hasan Bozkurt, MD, Department of Child and Adolescent Psychiatry, Medical Faculty Hospital, Gaziosmanpasa University, Tokat 60100, Turkey. Email: [email protected] Received 26 May 2014; revised 25 September 2014; accepted 6 November 2014.
tured Clinical Interview for DSM-IV Dissociative Disorders findings. Adolescents with dissociative identity disorder were found to have higher scores on the Adolescent Dissociative Experiences Scale and Child Posttraumatic Stress Reaction Index than the dissociative disorder–not otherwise specified group. Sexual and physical abuses were also found to be among the main traumatic events. Incest was reported in six cases of the study sample. All subjects had at least one comorbid psychiatric disorder. The most common psychiatric diagnoses were major depressive disorder (n = 25; 100%) and posttraumatic stress disorder (n = 22; 88%).
Conclusion: High psychiatric comorbidity rates were found in adolescents diagnosed with DD. A prevalent history of abuse and traumatic events was represented. Clinicians should be aware of the impacts of DD on adolescents’ mental health. Key words: adolescents, comorbidity, dissociation, psychiatric disorders.
can potentially disrupt every area of psychological functioning.1 DD usually begin in childhood in response to continuous traumatic and overwhelming life experiences. Despite this early beginning, a
doi:10.1111/pcn.12256
Regular Article
High psychiatric comorbidity in adolescents with dissociative disorders Hasan Bozkurt, MD,1* Tuba Duzman Mutluer, Salih Zoroglu, MD2
MD,2
Cigdem Kose,
PhD2
and
1
Department of Child and Adolescent Psychiatry, Faculty of Medicine, Gaziosmanpasa University, Tokat, and 2Department of Child and Adolescent Psychiatry, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
Aim: The aim of this study was to evaluate psychiatric comorbidity rates and patterns in a sample of clinically referred adolescents diagnosed with dissociative disorders (DD) by using a structured interview. Methods: All participants completed a comprehensive test battery, which consisted of a questionnaire for sociodemographic data and clinical history, Child Posttraumatic Stress Reaction Index, Childhood Abuse and Neglect Questionnaire and the Adolescent Dissociative Experiences Scale. Diagnosis was made by the Structured Clinical Interview for DSM-IV Dissociative Disorders. Psychiatric comorbidity was assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children – Present and Lifetime Version. Results: A total of 25 adolescent subjects aged 12–18 years participated in the study. Ten adolescents were diagnosed as having dissociative identity disorder and 15 of them were diagnosed as having dissociative disorder–not otherwise specified based on the Struc-
ISSOCIATIVE DISORDERS (DD) are characterized by a disruption and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior. Dissociative symptoms
D
*Correspondence: Hasan Bozkurt, MD, Department of Child and Adolescent Psychiatry, Medical Faculty Hospital, Gaziosmanpasa University, Tokat 60100, Turkey. Email: [email protected] Received 26 May 2014; revised 25 September 2014; accepted 6 November 2014.
tured Clinical Interview for DSM-IV Dissociative Disorders findings. Adolescents with dissociative identity disorder were found to have higher scores on the Adolescent Dissociative Experiences Scale and Child Posttraumatic Stress Reaction Index than the dissociative disorder–not otherwise specified group. Sexual and physical abuses were also found to be among the main traumatic events. Incest was reported in six cases of the study sample. All subjects had at least one comorbid psychiatric disorder. The most common psychiatric diagnoses were major depressive disorder (n = 25; 100%) and posttraumatic stress disorder (n = 22; 88%).
Conclusion: High psychiatric comorbidity rates were found in adolescents diagnosed with DD. A prevalent history of abuse and traumatic events was represented. Clinicians should be aware of the impacts of DD on adolescents’ mental health. Key words: adolescents, comorbidity, dissociation, psychiatric disorders.
can potentially disrupt every area of psychological functioning.1 DD usually begin in childhood in response to continuous traumatic and overwhelming life experiences. Despite this early beginning, a
