Neuropsychiatric Disease and Treatment (Dec 2017)

Brain functional integration: an epidemiologic study on stress-producing dissociative phenomena

  • Sperandeo R,
  • Monda V,
  • Messina G,
  • Carotenuto M,
  • Maldonato NM,
  • Moretto E,
  • Leone E,
  • De Luca V,
  • Monda M,
  • Messina A

Journal volume & issue
Vol. Volume 14
pp. 11 – 19

Abstract

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Raffaele Sperandeo,1,2,* Vincenzo Monda,3,* Giovanni Messina,4 Marco Carotenuto,5 Nelson Mauro Maldonato,1,2 Enrico Moretto,1,2 Elena Leone,1,2 Vincenzo De Luca,6 Marcellino Monda,3 Antonietta Messina3 1Department of Human Sciences, Università Della, Basilicata, 2School of Integrated Gestaltic Psychotherapy, Torre Annunziata, 3Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetic and Sport Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, 4Department of Clinical and Experimental Medicine, University of Foggia, Foggia, 5Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy; 6Department of Psychiatry, University of Toronto, Toronto, Canada *These authors contributed equally to this work Abstract: Dissociative phenomena are common among psychiatric patients; the presence of these symptoms can worsen the prognosis, increasing the severity of their clinical conditions and exposing them to increased risk of suicidal behavior. Personality disorders as long duration stressful experiences may support the development of dissociative phenomena. In 933 psychiatric outpatients consecutively recruited, presence of dissociative phenomena was identified with the Dissociative Experience Scale (DES). Dissociative phenomena were significantly more severe in the group of people with mental disorders and/or personality disorders. All psychopathologic traits detected with the symptom checklist-90-revised had a significant correlation with the total score on the DES. Using total DES score as the dependent variable, a linear regression model was constructed. Mental and personality disorders which were associated with greater severity of dissociative phenomena on analysis of variance were included as predictors; scores from the nine scales of symptom checklist-90-revised, significantly correlated to total DES score, were used as covariates. The model consisted of seven explanatory variables (four factors and three covariates) explaining 82% of variance. The four significant factors were the presence of borderline and narcissistic personality disorder, substance abuse disorders and psychotic disorders. Significant covariates were psychopathologic traits of anger, psychoticism and obsessiveness. This study, confirming Janet’s theory, explains that, mental disorders and psychopathologic experiences of patients can configure the chronic stress condition that produces functional damage to the adaptive executive system. The symptoms of dissociative depersonalization/derealization and dissociative amnesia can be explained, in large part, through their current and previous psychopathologic experiences. Keywords: mental disorders, personality disorders, amnesia, depersonalization/derealization 

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