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Dissociation

MedGen UID:: 88527
•Concept ID:: C0086168
•: Mental or Behavioral Dysfunction

Synonyms:	Dissociation - mental defense mechanism; Dissociative reaction
SNOMED CT:	Dissociation - mental defense mechanism (286669009)

HPO:	HP:0032940

Definition

Disruption or detachment of certain aspects of one's normal psychological functioning typically involves a disconnection or separation from thoughts, feelings, sensations, memories, or one's sense of identity or reality. [from HPO]

Term Hierarchy

GTR
MeSH

CClinical test, RResearch test, OOMIM, GGeneReviews, VClinVar

CROGVDissociation

Abnormality of the nervous system
- Abnormal nervous system physiology
  - Abnormality of mental function
    - Abnormal experience of reality
      - Abnormal interpretation of external stimuli
        Abnormal perceptual state
        Dissociation

Professional guidelines

PubMed

Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review.

Burback L, Brémault-Phillips S, Nijdam MJ, McFarlane A, Vermetten E
Curr Neuropharmacol 2024;22(4):557-635. doi: 10.2174/1570159X21666230428091433. PMID: 37132142 Free PMC Article

Long-term safety of ketamine and esketamine in treatment of depression.

Nikayin S, Murphy E, Krystal JH, Wilkinson ST
Expert Opin Drug Saf 2022 Jun;21(6):777-787. Epub 2022 Apr 19 doi: 10.1080/14740338.2022.2066651. PMID: 35416105

Treatment of bacterial prostatitis.

Lipsky BA, Byren I, Hoey CT
Clin Infect Dis 2010 Jun 15;50(12):1641-52. doi: 10.1086/652861. PMID: 20459324

See all (486)

Recent clinical studies

Etiology

Dissociation debates: everything you know is wrong.

Loewenstein RJ
Dialogues Clin Neurosci 2018 Sep;20(3):229-242. doi: 10.31887/DCNS.2018.20.3/rloewenstein. PMID: 30581293 Free PMC Article

The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms.

Choi KR, Seng JS, Briggs EC, Munro-Kramer ML, Graham-Bermann SA, Lee RC, Ford JD
J Am Acad Child Adolesc Psychiatry 2017 Dec;56(12):1062-1072. Epub 2017 Oct 4 doi: 10.1016/j.jaac.2017.09.425. PMID: 29173740 Free PMC Article

Self-injury and suicidality: the impact of trauma and dissociation.

Ford JD, Gómez JM
J Trauma Dissociation 2015;16(3):225-31. doi: 10.1080/15299732.2015.989648. PMID: 25760316

Neurophysiological correlates of dissociative symptoms.

van der Kruijs SJ, Bodde NM, Carrette E, Lazeron RH, Vonck KE, Boon PA, Langereis GR, Cluitmans PJ, Feijs LM, Hofman PA, Backes WH, Jansen JF, Aldenkamp AP
J Neurol Neurosurg Psychiatry 2014 Feb;85(2):174-9. Epub 2012 Nov 22 doi: 10.1136/jnnp-2012-302905. PMID: 23175855

Dissociative disorders in DSM-5.

Spiegel D, Loewenstein RJ, Lewis-Fernández R, Sar V, Simeon D, Vermetten E, Cardeña E, Dell PF
Depress Anxiety 2011 Sep;28(9):824-52. doi: 10.1002/da.20874. PMID: 21910187

See all (7856)

Diagnosis

Scapulothoracic dissociation.

Kani KK, Chew FS
Br J Radiol 2019 Sep;92(1101):20190090. Epub 2019 Jun 5 doi: 10.1259/bjr.20190090. PMID: 31046412 Free PMC Article

Dissociation in Psychiatric Disorders: A Meta-Analysis of Studies Using the Dissociative Experiences Scale.

Lyssenko L, Schmahl C, Bockhacker L, Vonderlin R, Bohus M, Kleindienst N
Am J Psychiatry 2018 Jan 1;175(1):37-46. Epub 2017 Sep 26 doi: 10.1176/appi.ajp.2017.17010025. PMID: 28946763

The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms.

Scapulothoracic dissociation.

Flanagin BA, Leslie MP
Orthop Clin North Am 2013 Jan;44(1):1-7. doi: 10.1016/j.ocl.2012.09.002. PMID: 23174321

Schizophrenia, dissociation, and consciousness.

Bob P, Mashour GA
Conscious Cogn 2011 Dec;20(4):1042-9. Epub 2011 May 23 doi: 10.1016/j.concog.2011.04.013. PMID: 21602061

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Therapy

Ketamine versus ECT for Nonpsychotic Treatment-Resistant Major Depression.

Anand A, Mathew SJ, Sanacora G, Murrough JW, Goes FS, Altinay M, Aloysi AS, Asghar-Ali AA, Barnett BS, Chang LC, Collins KA, Costi S, Iqbal S, Jha MK, Krishnan K, Malone DA, Nikayin S, Nissen SE, Ostroff RB, Reti IM, Wilkinson ST, Wolski K, Hu B
N Engl J Med 2023 Jun 22;388(25):2315-2325. Epub 2023 May 24 doi: 10.1056/NEJMoa2302399. PMID: 37224232

Use of ketamine and esketamine for depression: an overview of systematic reviews with meta-analyses.

Lima TM, Visacri MB, Aguiar PM
Eur J Clin Pharmacol 2022 Mar;78(3):311-338. Epub 2021 Oct 27 doi: 10.1007/s00228-021-03216-8. PMID: 34705064

MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study.

Mitchell JM, Bogenschutz M, Lilienstein A, Harrison C, Kleiman S, Parker-Guilbert K, Ot'alora G M, Garas W, Paleos C, Gorman I, Nicholas C, Mithoefer M, Carlin S, Poulter B, Mithoefer A, Quevedo S, Wells G, Klaire SS, van der Kolk B, Tzarfaty K, Amiaz R, Worthy R, Shannon S, Woolley JD, Marta C, Gelfand Y, Hapke E, Amar S, Wallach Y, Brown R, Hamilton S, Wang JB, Coker A, Matthews R, de Boer A, Yazar-Klosinski B, Emerson A, Doblin R
Nat Med 2021 Jun;27(6):1025-1033. Epub 2021 May 10 doi: 10.1038/s41591-021-01336-3. PMID: 33972795 Free PMC Article

Efficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Patients With Treatment-Resistant Depression: A Randomized Clinical Trial.

Daly EJ, Trivedi MH, Janik A, Li H, Zhang Y, Li X, Lane R, Lim P, Duca AR, Hough D, Thase ME, Zajecka J, Winokur A, Divacka I, Fagiolini A, Cubala WJ, Bitter I, Blier P, Shelton RC, Molero P, Manji H, Drevets WC, Singh JB
JAMA Psychiatry 2019 Sep 1;76(9):893-903. doi: 10.1001/jamapsychiatry.2019.1189. PMID: 31166571 Free PMC Article

Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study.

Popova V, Daly EJ, Trivedi M, Cooper K, Lane R, Lim P, Mazzucco C, Hough D, Thase ME, Shelton RC, Molero P, Vieta E, Bajbouj M, Manji H, Drevets WC, Singh JB
Am J Psychiatry 2019 Jun 1;176(6):428-438. Epub 2019 May 21 doi: 10.1176/appi.ajp.2019.19020172. PMID: 31109201

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Prognosis

His bundle pacing.

Payne J, Garlitski AC, Weinstock J, Homoud M, Madias C, Estes NAM
J Interv Card Electrophysiol 2018 Aug;52(3):323-334. Epub 2018 Aug 13 doi: 10.1007/s10840-018-0412-5. PMID: 30105429

The Clinical Significance of Relative Bradycardia.

Ye F, Hatahet M, Youniss MA, Toklu HZ, Mazza JJ, Yale S
WMJ 2018 Jun;117(2):73-78. PMID: 30048576

What we know and what we need to learn about the treatment of dissociative disorders.

Brand BL
J Trauma Dissociation 2012;13(4):387-96. doi: 10.1080/15299732.2012.672550. PMID: 22651673

Ketamine dependence.

Pal HR, Berry N, Kumar R, Ray R
Anaesth Intensive Care 2002 Jun;30(3):382-4. doi: 10.1177/0310057X0203000323. PMID: 12075653

Neonatal seizures.

Rennie JM
Eur J Pediatr 1997 Feb;156(2):83-7. doi: 10.1007/s004310050559. PMID: 9039506

See all (5210)

Clinical prediction guides

Dissociation in Psychiatric Disorders: A Meta-Analysis of Studies Using the Dissociative Experiences Scale.

Lyssenko L, Schmahl C, Bockhacker L, Vonderlin R, Bohus M, Kleindienst N
Am J Psychiatry 2018 Jan 1;175(1):37-46. Epub 2017 Sep 26 doi: 10.1176/appi.ajp.2017.17010025. PMID: 28946763

Implicit measures of "wanting" and "liking" in humans.

Tibboel H, De Houwer J, Van Bockstaele B
Neurosci Biobehav Rev 2015 Oct;57:350-64. Epub 2015 Sep 30 doi: 10.1016/j.neubiorev.2015.09.015. PMID: 26432503

Dissociation and memory fragmentation in post-traumatic stress disorder: an evaluation of the dissociative encoding hypothesis.

Bedard-Gilligan M, Zoellner LA
Memory 2012;20(3):277-99. Epub 2012 Feb 21 doi: 10.1080/09658211.2012.655747. PMID: 22348400 Free PMC Article

Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis.

Ozer EJ, Best SR, Lipsey TL, Weiss DS
Psychol Bull 2003 Jan;129(1):52-73. doi: 10.1037/0033-2909.129.1.52. PMID: 12555794

The Cambridge Depersonalization Scale: a new instrument for the measurement of depersonalization.

Sierra M, Berrios GE
Psychiatry Res 2000 Mar 6;93(2):153-64. doi: 10.1016/s0165-1781(00)00100-1. PMID: 10725532

See all (11612)

Recent systematic reviews

The Treatment of Depersonalization-Derealization Disorder: A Systematic Review.

Wang S, Zheng S, Zhang X, Ma R, Feng S, Song M, Zhu H, Jia H
J Trauma Dissociation 2024 Jan-Feb;25(1):6-29. Epub 2023 Jul 11 doi: 10.1080/15299732.2023.2231920. PMID: 37431255

Narcolepsy and psychosis: A systematic review.

Hanin C, Arnulf I, Maranci JB, Lecendreux M, Levinson DF, Cohen D, Laurent-Levinson C
Acta Psychiatr Scand 2021 Jul;144(1):28-41. Epub 2021 May 5 doi: 10.1111/acps.13300. PMID: 33779983 Free PMC Article

Hereditary transthyretin-related amyloidosis.

Finsterer J, Iglseder S, Wanschitz J, Topakian R, Löscher WN, Grisold W
Acta Neurol Scand 2019 Feb;139(2):92-105. Epub 2018 Oct 23 doi: 10.1111/ane.13035. PMID: 30295933

The relationship between dissociation and voices: A systematic literature review and meta-analysis.

Pilton M, Varese F, Berry K, Bucci S
Clin Psychol Rev 2015 Aug;40:138-55. Epub 2015 Jun 16 doi: 10.1016/j.cpr.2015.06.004. PMID: 26117061

Post-traumatic stress disorder.

Bisson JI
BMJ Clin Evid 2010 Feb 3;2010 PMID: 21718580 Free PMC Article

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MedGen

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Dissociation

Definition

Term Hierarchy

Professional guidelines

PubMed

Recent clinical studies

Etiology

Diagnosis

Therapy

Prognosis

Clinical prediction guides

Recent systematic reviews

Supplemental Content

Table of contents

Clinical resources

Practice guidelines

Consumer resources

Reviews

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