Dissociation in schizophrenia and borderline personality disorder

. 2014 ; 10 () : 487-91. [epub] 20140317

Status PubMed-not-MEDLINE Jazyk angličtina Země Nový Zéland Médium electronic-ecollection

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/pmid24672239

BACKGROUND: Dissociation likely plays a key role in schizophrenia and borderline personality disorder (BPD), although empirical studies that compare specific manifestations of these symptoms in schizophrenia and BPD are rare. In this context, the purpose of this study was to compare the occurrence of dissociative and other psychopathological symptoms in these disorders, and to assess the possible influence of antipsychotic medication on the dissociative symptoms. METHODS: We assessed 31 patients with schizophrenia and 36 patients with BPD. Dissociative symptoms were measured by the Dissociative Experiences Scale (DES), symptoms related to stress and traumatic experiences were assessed using the Trauma Symptom Checklist-40 (TSC-40), and other psychopathological symptoms were measured with the Health of the Nation Outcome Scales (HoNOS). We also assessed actual daily doses of antipsychotic medication in chlorpromazine equivalents in all participants. RESULTS: The results show that symptoms of traumatic stress measured by the TSC-40 had significantly higher scores in the BPD group. The data also show that dissociative symptoms (DES) were significantly correlated with symptoms of traumatic stress (TSC-40) and with symptoms assessed by the HoNOS. Remarkably significant correlations were found between levels of antipsychotic medication and the DES and between antipsychotic medication and the depersonalization/derealization component of the DES in BPD patients. CONCLUSION: The results support an important role of dissociative processes in schizophrenia and BPD and suggest a significant relationship between manifestations of dissociative symptoms in BPD and antipsychotic medication.

Zobrazit více v PubMed

Breuer J, Freud S. Studies in Hysteria. New York, NY, USA: Basic Books; 1895.

Stone MH. Toward a psychobiological theory of borderline personality disorder: Is irritability the red thread that runs through borderline conditions? Dissociation. 1988;1:2–15.

Bob P. Pain, dissociation and subliminal self-representations. Conscious Cogn. 2008;17:355–369. PubMed

Bob P. Dissociation, epileptiform discharges and chaos in the brain: toward a neuroscientific theory of dissociation. Act Nerv Super (Praha) 2012;54:84–107.

Hilgard ER. Divided Consciousness Multiple Control in Human Thought and Action. New York, NY, USA: Wiley; 1986.

Crawford HJ. Brain dynamics and hypnosis. Int J Clin Exp Hypn. 1994;42:204–232. PubMed

Rainville P, Hofbauer RK, Bushnell MC, Duncan GH, Price DD. Hypnosis modulates activity in brain structures involved in the regulation of consciousness. J Cogn Neurosci. 2002;14:887–901. PubMed

Vermetten E, Douglas BJ. Functional brain imaging and the induction of traumatic recall: a cross-correlational review between neuroimaging and hypnosis. Int J Clin Exp Hypn. 2004;52:280–312. PubMed

Bleuler E. In: Dementia Praecox or the Group of Schizophrenias. Zinkin J, translator. New York, NY, USA: International Universities Press; 1950.

Korzekwa MI, Dell PF, Links PS, Thabane L, Fougere P. Dissociation in borderline personality disorder: a detailed look. J Trauma Dissociation. 2009;10:346–367. PubMed

Zanarini MC, Jager-Hyman S. Dissociation in borderline personality disorder. In: Dell PF, O’Neil JA, editors. Dissociation and the Dissociative Disorders DSM-V and Beyond. New York, NY, USA: Routledge; 2009.

Zanarini MC, Frankenburg FR, Jager-Hyman S, et al. The course of dissociation for patients with borderline personality disorder and Axis II comparison subjects: a 10-year follow up. Acta Psychiatr Scand. 2008;118:291–296. PubMed PMC

Raven JC. Guide to the Standard Progressive Matrices. London, UK: HK Lewis; 1960.

Sheehan DV, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59( Suppl 20):22–33. PubMed

Woods SW. Chlorpromazine equivalent doses for the newer atypical antipsychotics. J Clin Psychiatry. 2003;64:663–667. PubMed

Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis. 1986;174:727–735. PubMed

Waller NG, Putnam FW, Carlson EB. Types of dissociation and dissociative types: a taxometric analysis of dissociative experiences. Psychol Methods. 1996;1:300–321.

Bob P. Dissociation processes and their measurement. Ceska Slov Psychiatr. 2000;96:301–309. Czech.

Ptacek R, Bob P, Paclt I. Dissociative experiences scale – Czech version. Cesk Psychol. 2006;50:262–272.

Elliott DM, Briere J. Sexual abuse trauma among professional women: validating the Trauma Symptom Checklist-40 (TSC-40) Child Abuse Negl. 1992;16:391–398. PubMed

Bob P, Ptacek R, Paclt I, et al. Dissociation and symptoms of complex partial epilepsy in depressed patients. Ceska Slov Psychiatr. 2003;99:82–88. Czech.

Wing JK, Curtis RH, Beevor AS. HoNOS: Health of the Nation Outcome Scales: Report on Research and Development Jul 1993–Dec 1995. London, UK: Royal College of Psychiatrists; 1996.

Pec O, Cechova D, Pecova J, et al. HoNOS (Health of the Nations Outcome Scales) – an adaptation of the tool for the assessment of symptoms and social functions in serious mentally ill in the Czech conditions and its use. Ceska Slov Psychiatr. 2009;105:245–249. Czech.

Kingdon DG, Ashcroft K, Bhandari B, et al. Schizophrenia and borderline personality disorder similarities and differences in the experience of auditory hallucinations, paranoia, and childhood trauma. J Nerv Ment Dis. 2010;198:399–403. PubMed

Putnam FW, Carlson EB, Ross CA, et al. Patterns of dissociation in clinical and nonclinical samples. J Nerv Ment Dis. 1996;11:673–679. PubMed

Brunner R, Parzer P, Schmitt R, Rescha F. Dissociative symptoms in schizophrenia: a comparative analysis of patients with borderline personality disorder and healthy controls. Psychopathology. 2004;37:281–284. PubMed

Read J, van Os J, Morrison AP, Ross CA. Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatr Scand. 2005;112:330–350. PubMed

Ross C, Anderson G, Clark P. Childhood abuse and positive symptoms of schizophrenia. Hosp Community Psychiatry. 1994;45:489–491. PubMed

Lysaker PH, Salyers MP. Anxiety symptoms in schizophrenia spectrum disorders: associations with social function, positive and negative symptoms, hope and trauma history. Acta Psychiatr Scand. 2007;116:290–298. PubMed

Lysaker PH, Meyer PS, Evans JD, Clements CA, Marks KA. Childhood sexual trauma and psychosocial functioning in adults with schizophrenia. Psychiatr Serv. 2001;52:1485–1488. PubMed

Lysaker PH, Nees MA, Lancaster RS, Davis LW. Vocational function among persons with schizophrenia with and without history of childhood sexual trauma. J Trauma Stress. 2004;17:435–438. PubMed

Janssen I, Krabbendam L, Bak M, et al. Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatr Scand. 2004;109:38–45. PubMed

Renard SB, Pijnenborg M, Lysaker PH. Dissociation and social cognition in schizophrenia spectrum disorder. Schizophr Res. 2012;137:219–223. PubMed

Sar V, Taycan O, Bolat N, et al. Childhood trauma and dissociation in schizophrenia. Psychopathology. 2010;43:33–40. PubMed

Schafer I, Fisher HL, Aderhold V, et al. Dissociative symptoms in patients with schizophrenia: relationships with childhood trauma and psychotic symptoms. Compr Psychiatry. 2012;53:364–371. PubMed

Moskowitz A, Read J, Farrelly S, Rudegeair T, Williams O. Are psychotic symptoms traumatic in origin and dissociative in kind? In: Dell PF, O’Neil JA, editors. Dissociation and the Dissociative Disorders DSM-V and Beyond. New York, NY, USA: Routledge; 2009.

Ross CA. The theory of dissociative subtype of schizophrenia. In: Dell PF, O’Neil JA, editors. Dissociation and the Dissociative Disorders DSM-V and Beyond. New York, NY, USA: Routledge; 2009.

Spitzer C, Haug HJ, Freyberger HJ. Dissociative symptoms in schizophrenic patients with positive and negative symptoms. Psychopathology. 1997;30:67–75. PubMed

Vogel M, Spitzer C, Barnow S, Freyberger HJ. The role of trauma and PTSD-related symptoms for dissociation and psychopathological distress in inpatients with schizophrenia. Psychopathology. 2006;39:236–242. PubMed

Vogel M, Kuwert P, Spitzer C, Möller B, Freyberger HJ, Grabe HJ. Association of childhood neglect with adult dissociation in inpatients with schizophrenia. Psychopathology. 2009;42:124–130. PubMed

Vogel M, Schatz D, Spitzer C, et al. A more proximal impact of dissociation than of trauma and posttraumatic stress disorder on Schneiderian symptoms in patients diagnosed with schizophrenia. Compr Psychiatry. 2009;50:128–134. PubMed

Howel EF, Blizard RA. Chronic relational trauma disorder: a new diagnostic scheme for borderline personality and the spectrum of dissociative disorders. In: Dell PF, O’Neil JA, editors. Dissociation and the Dissociative Disorders DSM-V and Beyond. New York, NY, USA: Routledge; 2009.

Weber K, Miller GA, Schupp HT, et al. Early life stress and psychiatric disorder modulate cortical responses to affective stimuli. Psychophysiology. 2009;46:1234–1243. PubMed

Barnow S, Arens EA, Sieswerda S, Dinu-Biringer R, Spitzer C, Lang S. Borderline personality disorder and psychosis: a review. Curr Psychiatry Rep. 2010;12:186–195. PubMed

Yan H, Tian L, Yan J, et al. Functional and anatomical connectivity abnormalities in cognitive division of anterior cingulate cortex in schizophrenia. PLoS One. 2012;7:e45659. PubMed PMC

Yücel M, Brewer WJ, Harrison BJ, et al. Anterior cingulate activation in antipsychotic-naïve first-episode schizophrenia. Acta Psychiatr Scand. 2007;115:155–158. PubMed

Botvinick MM, Cohen JD, Carter CS. Conflict monitoring and anterior cingulate cortex: an update. Trends Cogn Sci. 2004;8:539–546. PubMed

Kerns JG, Cohen JD, MacDonald AW, 3rd, Cho RY, Stenger VA, Carter CS. Anterior cingulate conflict monitoring and adjustments in control. Science. 2004;303:1023–1026. PubMed

Kerns JG, Cohen JD, MacDonald AW, 3rd, et al. Decreased conflict- and error-related activity in the anterior cingulate cortex in subjects with schizophrenia. Am J Psychiatry. 2005;162:1833–1839. PubMed

Najít záznam

Citační ukazatele

Nahrávání dat ...

Možnosti archivace

Nahrávání dat ...