Dissociative disorders and other psychopathological groups: exploring the differences through the Somatoform Dissociation Questionnaire (SDQ-20)

The Somatoform Dissociation Questionnaire is a self-report questionnaire that has proven to be a reliable and valid instrument. The objectives of this study were to validate the Portuguese version and to determine its capability to distinguish patients with dissociative disorders from others with psychopathological disorders. Method: 234 patients answered the translated version of Somatoform Dissociation Questionnaire. The Portuguese Dissociative Disorders Interview Schedule was used to validate clinical diagnosis. Patients with dissociative disorder (n = 113) were compared to a control group of 121 patients with various anxiety and depression disorders. Results: Reliability measured by Cronbach’s α was 0.88. The best performance of the Portuguese form was at a cut-off point of 35, which distinguishes between dissociative disorder and neurotic disorders with a good diagnostic efficacy (sensitivity = 0.73). The somatoform dissociation was significantly more frequent in dissociative disorder patients, conversion disorder patients and post-traumatic stress disorder patients. Conclusions: These findings suggest that dissociative disorders can be differentiated from other psychiatric disorders through somatoform dissociation. The Portuguese version of the Somatoform Dissociation Questionnaire has fine psychometric features that sustain its cross-cultural validity

Portuguese Validation of the Dissociative Experiences Scale (DES)

Objective: The Dissociative Experiences Scale (DES) is a widely used screening tool for dissociative symptoms. The aim of the present study was to evaluate the validity and internal consistency of a Portuguese version and determine if it accurately identified dissociative pathology. Method: The original DES underwent a “forward–backward” translation process. The translated form was used on 570 participants divided into 3 subgroups: 113 patients with dissociative symptoms, 233 psychiatric patients with vari- ous psychopathological disorders, and 224 normal individuals. Results: A principal components analysis with all of the partici- pants yielded 4 factors that accounted for 56.3% of the variance. Reliability as measured by Cronbach’s alpha was .94. The receiver operating characteristic curve applied to the cutoff analysis revealed a value of 30 comparing the 2 clinical groups and con- trasting the dissociative-based group with the nonclinical group. The ability of the DES to correctly classify those with and without the disease was very good. Sensitivity was 65.0% and specificity was 86.0% with the cutoff score of 30 from the comparison between dissociative symptomatic disorders and the other psychopathological disorders. Comparing the dissociative symptomatic group with the nonclinical group, we found that sensitivity was 65.0% and specificity was 100%. The mean DES scores for the 3 subgroups were significantly different. Conclusion: These findings are in some degree analogous to those in other studies and suggest that the DES is a reliable and valid screen for the Portuguese population

Psychiatric Symptoms and Dissociation in Conversion, Somatization and Dissociative Disorders

Objective: Conversion, dissociation and somatization are historically related in the long established concept of hysteria. Somewhere along the way they were separated due to the Cartesian dualistic view. The aim of the present study was to compare these pathologies and investigate whether symptoms of these pathologies overlap in their clinical appearance in a Portuguese sample. Method: Twenty-six patients with conversion disorder, 38 with dissociative disorders, 40 with somatization disorder, and a comparison group of 46 patients having other psychiatric disorders answered questions about dissociation (Dissociative Experiences Scale), somatoform dissociation (Somatoform Dissociation Questionnaire), and psychopathological symptoms (Brief Symptom Inventory). Results: Dissociative and somatoform symptoms were significantly more frequent in dissociative and conversion disorder than in somatization disorder and controls. There were no significant differences between dissociative and conversion patients. Conclusions: Conversion disorder is closely related to dissociative disorders. These results support the ICD-10 categorization of conversion disorder among dissociative disorders and the hypothesis of analogous psychopathological processes in conversion and dissociative disorders versus somatization disorder

Demographic and Mental Health Factors Associated with Pathological Dissociation in a Portuguese Sample

Pathological dissociation has been extensively studied in many countries; however, little is known about it in Portugal. This research examined the role of demographic variables and mental health on dissociation in Portugal. We assessed 505 participants from 6 samples consisting of dissociative patients (n = 37), conversive patients (n = 26), somaticizing patients (n = 59), posttraumatic stress disorder patients (n = 50), other psy- chiatric patients (n = 174), and nonclinical subjects (n = 159). Dissociation was measured by Portuguese versions of the Dissociative Experiences Scale and Somatoform Dissociation Questionnaire; the LEAD procedure and subscales of the Brief Symptom Inventory indicated mental health. Pathological psychological dissociation was significantly more frequent in women, in the youngest of the participants, and in those with less education. Multiple logistic regression revealed that psychoticism, paranoid ideation, and depression symptoms made both men and women more vulnerable to psychological dissociation. Furthermore, psychological dissociation was more probable in men having symptoms of obsession and paranoid ideation and in women having symptoms of psychoticism and paranoid ideation. Pathological somatoform dissociation was significantly more probable in women with less education. Moreover, somatoform dissociation was more likely in women with somatization symptoms and more likely in men with symptoms of somatization and psychoticism. Even though significant associations were found, causal relations could not be established because the study was cross-sectional

Visão de Si Reflectida pela Visão dos Outros

A ideia de que a pessoa com Distúrbio de Personalidade não se vê como os outros a vêem está arreigada entre os profissionais de saúde mental. Neste artigo são apresentados os resultados principais de um estudo de investigação com o objectivo de questionar essa ideia. Este trabalho consistiu na comparação das correlações das várias escalas do Adjective Check List (ACL) entre a auto e heterodescrição num grupo de 21 sujeitos diagnosticados com Patologia da Personalidade e noutro com 22 sujeitos sem esse diagnóstico. Os resultados apontam para uma melhor adequação entre as auto-descriçoes e hetero-descrições nos indivíduos com distúrbio de personalidade, o que contraria aquela ideia. The present investigation examined the idea that people with Personality Disordes (PD) doesn’t see himself as others see them. This study compared correlations of the different scales of Adjective Check List (ACL) between self-description and hetero-description in 21 PD patients and 22 patients of group control (with other disorders than depression or psychosis). PD patients showed a greater significant correlation between self and hetero-description than the controls. These findings suggest that PD. patients gess more accurately the perceptions that others make about themselves. Some desiderata for future research on these findings are raised

Versão Portuguesa da Dissociative Disorders Interview Schedule (DDIS) Estudo preliminar de adaptação a uma amostra da população portuguesa

Objectivo: A detecção precoce de patologia dissociativa é essencial para o seu tratamento. O uso de instrumentos padronizados de avaliação diagnóstica é útil nessa tarefa. O objectivo deste estudo é adaptar o Dissociative Disorders Interview Schedule (DDIS) e determinar provisoriamente algumas propriedades psicométricas. Método: O DDIS foi traduzido para Português e retrovertido para Inglês de forma a garantir a sua base conceptual. O estudo incluiu 61 doentes com patologias do foro dissociativo, conversivo, somático e outras patologias. A validade convergente da DDIS foi estudada com as versões portuguesas do Somatoform Dissociation Questionnaire (SDQ-20) e do Dissociative Experiences Scale (DES). A concordância diagnóstica foi calculada através do Kapa de Cohen. Resultados: As correlações com os outros instrumentos de medida foram moderadas. A concordância diagnóstica foi alta (0.83). A sensibilidade foi de 69% e a especificidade de 91%. Conclusões: a versão Portuguesa do DDIS parece ser um instrumento útil para identificar e discriminar doentes do foro dissociativo de outros doentes. As características psicométricas auguram validade e fidedignidade promissoras

Demographic and Mental Health Factors Associated with Pathological Dissociation in a Portuguese Sample

ABSTRACT. Pathological dissociation has been extensively studied in many countries; however, little is known about it in Portugal. This research examined the role of demographic variables and mental health on dissociation in Portugal. We assessed 505 participants from 6 samples consisting of dissociative patients (n = 37), conversive patients (n = 26), somaticizing patients (n = 59), posttraumatic stress disorder patients (n = 50), other psychiatric patients (n = 174), and nonclinical subjects (n = 159). Dissociation was measured by Portuguese versions of the Dissociative Experiences Scale and Somatoform Dissociation Questionnaire; the LEAD procedure and subscales of the Brief Symptom Inventory indicated mental health. Pathological psychological dissociation was significantly more frequent in women, in the youngest of the participants, and in those with less education. Multiple logistic regression revealed that psychoticism, paranoid ideation, and depression symptoms made both men and women more vulnerable to psychological dissociation. Furthermore, psychological dissociation was more probable in men having symptoms of obsession and paranoid ideation and in women having symptoms of psychoticism and Helena Espirito Santo is affiliated with the Department of Psychology at Instituto Superior Miguel Torga in Portugal. José Luís Pio-Abreu is affiliated with the Department of Psychiatry and Department of Psychotherapy at the Hospitais da Universidade de Coimbra in Portugal. Address correspondence to: Dr. Helena Espirito Santo, Department of Psychology, Instituto Superior Miguel Torga, R. Augusta 46, 3000-061 Coimbra, Portugal (E-mail: [email protected]). JOURNAL OF TRAUMA & DISSOCIATION paranoid ideation. Pathological somatoform dissociation was significantly more probable in women with less education. Moreover, somatoform dissociation was more likely in women with somatization symptoms and more likely in men with symptoms of somatization and psychoticism. Even though significant associations were found, causal relations could not be established because the study was cross-sectional

Versão Portuguesa da Dissociative Disorders Interview Schedule (DDIS)

Objectivo: A detecção precoce de patologia dissociativa é essencial para o seu tratamento. O uso de instrumentos padronizados de avaliação diagnóstica é útil nessa tarefa. O objectivo deste estudo é adaptar o Dissociative Disorders Interview Schedule (DDIS) e determinar provisoriamente algumas propriedades psicométricas. Método: O DDIS foi traduzido para Português e retrovertido para Inglês de forma a garantir a sua base conceptual. O estudo incluiu 61 doentes com patologias do foro dissociativo, conversivo, somático e outras patologias. A validade convergente da DDIS foi estudada com as versões portuguesas do Somatoform Dissociation Questionnaire (SDQ-20) e do Dissociative Experiences Scale (DES). A concordância diagnóstica foi calculada através do Kapa de Cohen. Resultados: As correlações com os outros instrumentos de medida foram moderadas. A concordância diagnóstica foi alta (0.83). A sensibilidade foi de 69% e a especificidade de 91%. Conclusões: a versão Portuguesa do DDIS parece ser um instrumento útil para identificar e discriminar doentes do foro dissociativo de outros doentes. As características psicométricas auguram validade e fidedignidade promissoras

ANALYSIS OF THE PREVALENCE OF MENTAL DISORDERS IN PSORIASIS: THE RELEVANCE OF PSYCHIATRIC ASSESSMENT IN DERMATOLOGY

Background: The boundary between Dermatology and Psychiatry has increasing recognition. Psoriasis is a common psychophysiological skin disease with a major impact on patient’s quality of life and a paradigmatic example of a pathology in that boundary. Studies are needed to exactly point out the prevalence of specific psychopathology and mental disorders associated with psoriasis. This work intends to analyse the prevalence of psychopathology and psychiatric comorbidities in patients with psoriasis. Methods: A systematic review of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the "5S" model proposed by Haynes. From all the papers retrieved by this search, a total of 34 papers met the inclusion criteria and were then deeply analysed. Results: The most prevalent mental disorders in these patients are sleep disorders (average prevalence: 62.0%), sexual dysfunction (45.6%), personality (35.0%), anxiety (30.4%), adjustment (29.0%), depressive (27.6%) and substance-related and addictive disorders (24.8%). Other mental disorders have been less described, namely somatic symptoms and related disorders, schizophrenia and other psychoses, bipolar disorder and eating disorders. Conclusions: This updated research shows that the prevalence of psychiatric conditions in psoriasis may range from 24% to 90%. The study of the mind-skin connection in psoriasis may improve the knowledge about psoriasis and its psychiatric comorbidities. The link between psoriasis and associated mental disorders is frequently forgotten or not considered in the clinical practice. Psychiatric disorders in patients with psoriasis may be underdiagnosed. These patients would really benefit from psychiatric assessment, with therapeutic relevance