Dissociative Model in Patients With Resistant Schizophrenia
G. Panov
Frontiers in Psychiatry February 15, 2022 DOI: 10.3389/fpsyt.2022.845493 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Correlation study Peer reviewed |
|---|---|
| Sample size | 106 |
| Population | Patients with schizophrenia, comprising 45 with treatment-resistant schizophrenia and 60 in clinical remission |
| Measures | Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS), Dissociative Experiences Scale (DES) |
| Key points | Patients with treatment-resistant schizophrenia had more than twice the level of dissociative symptoms on the DES compared with patients in clinical remission, with the resistant group's scores reaching levels seen in dissociative identity disorder. The authors argue this difference suggests that resistance to antipsychotic treatment is associated with high dissociation and that non-antipsychotic treatment options and earlier diagnostic strategies should be considered. |
Abstract
Background: Schizophrenia is a severe mental illness in which, despite the growing number of antipsychotics from 30 to 50% of patients remain resistant to treatment. Many resistance factors have been identified. Dissociation as a clinical phenomenon is associated with a loss of integrity between memories and perceptions of reality. Dissociative symptoms have also been found in patients with schizophrenia of varying severity. The established dispersion of the degree of dissociation in patients with schizophrenia gave us reason to look for the connection between the degree of dissociation and resistance to therapy.
Methods: The type of study is correlation analysis. 106 patients with schizophrenia were evaluated. Of these, 45 with resistant schizophrenia and 60 with clinical remission. The Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) scales were used to assess clinical symptoms. The assessment of dissociative symptoms was made with the scale for dissociative experiences (DES). Statistical methods were used to analyze the differences in results between the two groups of patients.
Results: Patients with resistant schizophrenia have a higher level of dissociation than patients in remission. This difference is significant and demonstrative with more than twice the level of dissociation in patients with resistant schizophrenia. The level of dissociation measured in patients with resistant schizophrenia is as high as the points on the DES in dissociative personality disorder.
Conclusion: Patients with resistant schizophrenia have a much higher level of dissociation than patients in clinical remission. The established difference between the two groups support to assume that resistance to the administered antipsychotics is associated with the presence of high dissociation in the group of resistant patients. These results give us explanation to think about therapeutic options outside the field of antipsychotic drugs as well as to consider different strategies earlier in the diagnostic process.
Citations in the library
Cited by 2
Cites 4
- Dissociative experiences as mediators between childhood trauma and auditory hallucinations. Journal of Traumatic Stress June 1, 2012
- Sleep normalization and decrease in dissociative experiences: evaluation in an inpatient sample. Journal of Abnormal Psychology February 2012
- Auditory Hallucinations: Psychotic Symptom or Dissociative Experience? Trauma and Serious Mental Illness January 4, 2008
- Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease December 1, 1986