Evaluating the Impact of Dissociation in Psychiatric Disorders


  • Ionuț Dragoș Rădulescu Psychiatrist, Hospital of Psychiatry “Elisabeta Doamna”, Galati
  • Alexandru Bogdan Ciubara Associate Professor, Department of Clinic surgical, “Dunarea de Jos” University of Galati
  • Codrina Moraru Resident psychiatrist, Socola Institute of Psychiatry, Iasi
  • Stefan Lucian Burlea Lecturer University of Medicine and Pharmacy Gr. T. Popa Iasi
  • Anamaria Ciubară Psychiatrist, Hospital of Psychiatry “Elisabeta Doamna”, Galati & Professor, Department of Psychiatry, “Dunarea de Jos” University of Galati




Dissociation, Dissociative Experiences Scale (DES), Psychiatric Disorders


Introduction: Dissociative symptoms are present in a various number of psychiatric disorders and are viewed as a major risk factor for suicidal and self-destructive behavior. Dissociation is defined in DSM-5 as a “disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior”. Assessing dissociation within different categories of mental disorders can be used to predict symptom severity and nonresponse to psychotherapeutic treatments. The most important tool in this process is the Dissociative Experiences Scale (DES). The purpose of the current study is to extend the understanding of dissociation in Psychiatric Disorders.

Material and methods: The current study used PubMed and Cochrane databases to identify relevant articles that refer to the subject of dissociation in Psychiatric Disorders.

Results and Discussions: Dissociation and dissociative disorders have been at the root of continuous controversy in psychiatric and psychology communities. The general confusion comes from the reduced conceptual distinction between dissociation as a symptom, process, deficit and psychological defense. At the high end of the DES score we find dissociative disorders, but closely followed by posttraumatic stress disorder, borderline personality disorder and conversion disorder with eating disorders, schizophrenia and anxiety disorders at midrange and the lowest scoring DES psychiatric disorder is found in bipolar disorders. Early intervention, based on these scores, show major improvement in maladaptive functionality, suicidal and self-destructive behavior, coupled with a reduction in total treatment cost.

Conclusions: There is a significant benefit in careful assessment of dissociative symptoms for the entire spectrum of mental disorders. There is a major need to raise awareness in all mental health facilities, of the value that this has in the current clinical setting.


Bob, P., Mashour, G. A. (2011). Schizophrenia, dissociation, and consciousness. Consciousness and Cognition., 20(4), 1042-1049. https://doi.org/10.1016/j.concog.2011.04.013

Burlea, G., Burlea, A. M., & Milici, R. C. (2010). Prevention and intervention in speech and language therapy for the success of lexicographical acquisitions. Revista de Cercetare si Interventie Sociala, 30, 86-100. https://www.rcis.ro/en/section1/40-volumul-302010septembrie/315-prevention-and-intervention-in-speech-and-language-therapy-for-the-success-of-lexicographical-acquisitions.html

Dalenberg, C. J., Brand, B. L., Gleaves, D. H., Dorahy, M. J., Loewenstein, R. J., Cardena, E., & Spiegel D. (2012). Evaluation of the evidence for the trauma and fantasy models of dissection. Psychological Bull., 138,550-588. https://doi.org/10.1037/a0027447

Damasio, A. (1999). The Feeling of What Happens. Body and Emotions in the Making of Conciousness. Harcourt Brace

Evren, C., Sar, V., Karadag, F., Gurol, D. T., & Karagoz, M. (2007) Dissociative disorders among alcohol-dependent inpatients. Psychiatry Res., 152(2-3), 233–241. https://doi.org/10.1016/j.psychres.2005.08.004

Feeny, N. C., Zoellner, L. A., & Fitzgibbons, L. A., Foa, E. B. (2000) Exploring the roles of emotional numbing, depression, and dissociation in PTSD. Journal of Traumatic Stress., 13(3), 489-498. https://doi.org/10.1023/A:1007789409330

Foote, B., & Park, J. (2008). Dissociative identity disorder and schizophrenia: Differential diagnosis and theoretical issues. Current Psychiatry Reports, 10, 217–222. https://doi.org/10.1007/s11920-008-0036-z

Forner, C. (2019). What mindfulness can learn about dissociation and what dissociation can learn from mindfulness. Journal of Trauma & Dissociation, 20(1), 1–5. https://doi.org/10.1080/15299732.2018.1502568

Guardia, D., Conversy, L., Jardri, R., Lafargue, G., Thomas, P., Dodin, V., Cottencin, O., Luyat, M. (2012) Imagining one’s own and someone else’s body actions: Dissociation in anorexia nervosa. PLoS ONE, 7(8), e43241. https://doi.org/10.1371/journal.pone.0043241

Jureidini, J., & Taylor, D. C. (2002). Hysteria. European Child & Adolescent Psychiatry, 11, 123–128. https://doi.org/10.1007/s00787-002-0267-1

Jureidini, J. (2004). Does dissociation offer a useful explanation for psychopathology? Psychopathology, 37(6), 259–265. https://doi.org/10.1159/000081981

Kihlstrom, J.F. (1984). Conscious, subconscious, unconscious: A cognitive view. In K. S., Bowers, & D. Meichenbaum (Eds.), The Unconscious Reconsidered (pp. 149–211). Wiley.

Loewenstein, R. J. (2018). Dissociation debates: Everything you know is wrong. Dialogues in Clinical Neuroscience, 20(3), 229–242. https://doi.org/10.31887/DCNS.2018.20.3/rloewenstein

Lyssenko, L., Schmahl, C., Bockhacker, L., Vonderlin, R., Bohus, M., Kleindienst, N. (2017). Dissociation in psychiatric disorders: a meta-analysis of studies using the dissociative experiences scale. American Journal of Psychiatr, 175, 37–46. https://doi.org/10.1176/appi.ajp.2017.17010025

Lupu, V. V., Ignat, A., Paduraru, G., Mihaila, D., Burlea, M., & Ciubara, A. (2015). Heterotopic Gastric Mucosa in the Distal Part of Esophagus in a Teenager Case Report. Medicine, 94(42). https://doi.org/10.1097/MD.0000000000001722

Nijenhuis, E. R. S., & Van der Hart, O. (2011). Dissociation in trauma: a new definition and comparison with previous formulations. Journal of Trauma & Dissociation, 12, 416–445. https://doi.org/10.1080/15299732.2011.570592

Paris, J. (2012). The rise and fall of dissociative identity disorder. The Journal of Nervous and Mental Disease, 200(12), 1076-1079. https://doi.org/10.1097/NMD.0b013e318275d285

Rufer, M., Fricke, S., Held. D., Cremer, J., & Hand, I. (2006) Dissociation and symptom dimensions of obsessive-compulsive disorder: a replication study. European Archives of Psychiatry and Clinical Neuroscience, 256, 146–150. https://doi.org/10.1007/s00406-005-0620-8

Sar, V., Taycan, O., Bolat, N., Özmen, M., Duran, A., Öztürk, E., & Ertem-Vehid, H. (2010). Childhood trauma and dissociation in schizophrenia. Psychopathology, 43, 33–40. https://doi.org/10.1159/000255961

Spiegel, D., Loewenstein, R J., Lewis-Fernandez, R., Sar, V. Simeon, D., Vermetten, E., Cardeña. E., & Dell, P. F. (2011). Dissociative disorders in DSM-5. Depression & Anxiety, 28(9), 824–852. https://doi.org/10.1002/da.20874

Soffer-Dudek, N. (2014). Dissociation and dissociative mechanisms in panic disorder, obsessive-compulsive disorder, and depression: a review and heuristic framework. Psychology of Consciousness: Theory, Research, and Practice, 1(3), 243–270. https://doi.org/10.1037/cns0000023

Spiegel, D. (2003). Hypnosis and traumatic dissociation: Therapeutic opportunities. Journal of Trauma and Dissociation, 4 (3), 73 – 90. https://doi.org/10.1300/J229v04n03_05

Terhune, D. B., Cardena, E., & Lindgren, M. (2011). Dissociative tendencies and individual differences in high hypnotic suggestibility. Cognitive Neuropsychiatry, 16(2), 113–135. https://doi.org/10.1080/13546805.2010.503048

Van Ijzendoorn, M. H, & Schüngel, C. (1996). The measurement of dissociation in normal and clinical populations: meta-analytic validation of the Dissociative Experiences Scale (DES). Clinical Psychology Review, 16, 365–382. https://core.ac.uk/download/pdf/15589623.pdf

Weissenborn, R, & Duka, T. (2000). State-dependent effects of alcohol on explicit memory: The role of semantic associations. Psychopharmacology, 149, 98–106. https://doi.org/10.1007/s002139900349

Wieder, L., & Terhune, D. B. (2019). Trauma and anxious attachment influence the relationship between suggestibility and dissociation: A moderated-moderation analysis. Cognitive Neuropsychiatry, 24(3), 191–207. https://doi.org/10.1080/13546805.2019.1606705




How to Cite

Rădulescu, I. D., Ciubara, A. B., Moraru, C., Burlea, S. L., & Ciubară, A. . (2020). Evaluating the Impact of Dissociation in Psychiatric Disorders. BRAIN. Broad Research in Artificial Intelligence and Neuroscience, 11(3Sup1), 163-174. https://doi.org/10.18662/brain/11.3Sup1/132

Most read articles by the same author(s)

1 2 3 4 > >> 

Publish your work at the Scientific Publishing House LUMEN

It easy with us: publish now your work, novel, research, proceeding at Lumen Scientific Publishing House

Send your manuscript right now