Psychiatria pre prax 1/2009

Disociative disorders in practice

disociative disorders are represented by different highly expressive symptoms, which are developped by the hypothetical mechanism of dissociation. Unbearable emotions, memories and thoughts are dissociated from the conscious part of psyche and represent the origin for different psychic and somatic symptoms. Most of the dissociative disorders are triggered by the psychic trauma in childhood or adult hood. The most serious course and ooutcome have pacients with psychogenic non-epileptic seizures, which are frequently by mistake treated for epilepsy. Causal treatment is not known, psychoterapy should enhance the general psychic stability, eventually to rediscover the dissociated material and to reintegrate it to the conscious part of psyche. Pharmacotherapy is focused on the treatment of depressive and anxious symptoms (SSRI) and thought disorders (atypical antipsychotics).

Keywords: dissociation, non-epileptic seizures, psychical trauma