Dissociative Disorders
Normally, people experience their consciousness, body, perceptions, memories, identity and emotions as connected and integrated. Dissociative symptoms involve a sense of disruption to how these things fit together. They often occur in response to stress or a traumatic event and can last anywhere from a few minutes to many years. The three types of dissociative disorder are described below (although dissociative symptoms can occur in other conditions, such as borderline personality disorder and post-traumatic stress disorder).
Depersonalisation-derealisation disorder involves depersonalisation, which is a feeling of being separated or outside their body, and derealisation, which is a feeling that the world is not real.
Dissociative amnesia involves forgetting autobiographical information (details about themselves and events that have happened to them), typically following a traumatic experience and leading to gaps in their memory.
Dissociative identity disorder was previously called multiple personality disorder. It involves a lack of a clear individual identity, with multiple separate identities with unique names, personalities and memories. It is often associated with severe stress and trauma in childhood.
Catatonia
Catatonia involves abnormal movement, communication and behaviour. It can present in a variety of ways. Patients are awake but not behaving normally. They may hold unusual postures, perform odd actions, repeat sounds or words, or remain blank and unresponsive. The symptoms can vary in severity over time.
The most common causes are severe depression and bipolar disorder. It can also occur with psychosis, such as in schizophrenia. Rarely, physical health conditions, such as strokes or brain tumours, can lead to catatonia.
Reactive Attachment Disorder
Reactive attachment disorder results from severe neglect and trauma in early childhood. It results in emotional withdrawal and inhibition, sadness, fearfulness, irritability and impaired cognition. They struggle to form close relationships or attachments and do not respond well to affection or discipline.
Attachment theory describes the importance of creating healthy, consistent and secure attachments to at least one nurturing individual during early childhood, particularly for the first two years of life. This creates a stable and secure base for the child to grow and develop. Reactive attachment disorder is a consequence of a severe absence of healthy attachments.
Factitious Disorder
Factitious disorder, also known as Munchausen Syndrome, involves a conscious effort to fake illness and seek medical attention for personal gain. The symptoms are invented, exaggerated or induced (through self-injury). Faking symptoms provides attention, affection, relationships and care from others. The sick role offers a sense of identity. They may get satisfaction from puzzling medical professionals. It can lead to significant and unnecessary investigations and interventions.
Patients with factitious disorder may have repeated presentations with inconsistent and dramatic symptoms that do not fit with examination and investigation findings.
Hoarding Disorder
Hoarding disorder features the excessive accumulation of possessions and emotional difficulty getting rid of items. This leads to enormous amounts of stuff in the home, significantly impacting daily living. The volume of clutter in the home increases the risk of food contamination, falls, fires, and infestations.
Those with hoarding disorder may not see the behaviour as a problem or appreciate its impact on themselves and others. They may have insight and experience feelings of guilt or embarrassment. It may be associated with self-neglect, depression and anxiety.
Alien Hand Syndrome
Alien hand syndrome involves the patient losing control of one of their hands. The hand acts independently, with a mind of its own. It may perform spontaneous actions, such as touching body parts or grabbing objects. It is usually the result of an underlying brain lesion, such as brain tumours, injuries, aneurysms, or following brain surgery.
Cotard Delusion
Cotard delusion involves the false belief (delusion) that they are dead or actively dying. It is also known as walking corpse syndrome. It is most often caused by psychiatric conditions, such as depression and schizophrenia, but can be caused by neurological conditions, such as brain tumours and migraines.
Capgras Syndrome
Capgras syndrome involves the false belief (delusion) that an identical duplicate has replaced someone close to them. This might be their spouse, family member or close friend. The person may be suspicious and aggressive towards the imposter.
Capgras syndrome is a delusional misidentification syndrome. It is most often seen in psychotic conditions, such as schizophrenia. It can also occur with dementia and other neurological conditions.
De Clérambault’s Syndrome
De Clérambault’s syndrome, also called erotomania, involves the false belief (delusion) that a famous or high-social-status individual is in love with the patient. This can lead to inappropriate harassment of the individual by the patient. The patient is most often a young, single woman. The patient usually has little or no contact with the individual and no objective evidence to support their belief. Frequently, it occurs without other psychiatric or neurological disease.
Alice in Wonderland Syndrome
Alice in wonderland syndrome, also known as Todd syndrome, involves incorrectly perceiving the sizes of body parts or objects. For example, the person may perceive their hands as being excessively large or small. It is also associated with changes to the perception of time (e.g., time passing fast or slow) and symptoms of migraines (e.g., aura and headache). The symptoms are intermittent. Causes include migraine, epilepsy, and brain tumours.
Koro Syndrome
Koro syndrome involves a false belief (delusion) that the sex organs (particularly the penis) are retracting or shrinking and will ultimately disappear. Patients may believe that this will eventually lead to death. This causes anxiety and panic attacks. Cases are primarily reported in Asia, particularly China and India, and Koro has been linked to cultural beliefs in these regions.
Body Integrity Dysphoria
Body integrity dysphoria, previously called apotemnophilia, involves a strong feeling that part of the body, for example, one or both of the legs, does not belong to them. The healthy body part causes them distress, and they typically want to remove that part of their body. They may have a desire to be disabled or paralysed and to use a wheelchair. It is not associated with psychiatric or neurological conditions.
Foreign Accent Syndrome
Foreign access syndrome involves a sudden change in a person’s voice. Others may perceive them as having a changed accent. They are aware that their voice has changed. The new speech pattern or accent is not connected with someone’s previous experience (e.g., speaking a second language associated with the new accent). The most common cause is stroke in the left hemisphere.
Functional Neurological Disorder
Functional neurological disorder, sometimes called conversion disorder, involves sensory and motor symptoms that are not explained by any neurological disease and may be caused by underlying psychosocial factors. Symptoms can include weakness, gait disturbance, seizures, sensory loss and vision disturbances. There may be a history of significant trauma or stress. The symptoms are not under the patient’s control and can cause considerable distress and functional impairment.
Last updated June 2024
Now, head over to members.zerotofinals.com and test your knowledge of this content. Testing yourself helps identify what you missed and strengthens your understanding and retention.
