DR Medhat MRCP

5. Dissociative disorder
- Dissociation is a process of 'separating off' certain memories from normal
consciousness
• Features :
- In contrast to conversion disorder, it involves psychiatric symptoms e.g. Amnesia,
fugue, stupor , depersonalization.
- Dissociative identity disorder (DID) is the new term for multiple personality disorder
as is the most severe form of dissociative disorder.
Type
Characterestics
Amnesia. Sudden inability to recall periods of past life or own identity
Fugue
Travel away from usual surroundings, amnesia for past
identity & sometimes may even assume new identity.
Identity disorder Presence of ≥ 2 distinct identities/personality states
Depersonalization Change in an individual's self-awareness such that they feel
detached from their own experience with the self, the body
and mind seeming alien. individual is in “ a dream like state”
Derealization Change in an individual's experience of the environment
where the patient feels that the world around him has changed
& he feels unfamilial with the people around him.
6. Factitious disorder (=Munchausen's syndrome)
- Mental disorder where the patients intend to cause sings & symptoms and they have
an inner need to be seen as ill or injured &seeking for hospitalization or even wiling
to do invasive procedures in order to get the sympathy and special attention given to
people who are truly ill ,not to achieve a concrete benefit, such as financial gain.
- Usually diagnosed by psychological , physical symptoms or both.
7. Body dysmorphic disorder (= dysmorphophobia)
- Is a mental disorder where patients have a significantly distorted body image
• Diagnostic and Statistical Manual (DSM) IV criteria:
Preoccupation with an imagine defect in appearance.
If a slight physical anomaly is present, the person’s concern is markedly excessive.
The preoccupation causes clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
The preoccupation is not better accounted for by another mental disorder (e.g.,
dissatisfaction with body shape and size in Anorexia Nervosa).
25