a Department of Psychology , Université de Montréal, Montreal, Quebec, Canada; and Hôpital Louis-H. Lafontaine , Montreal , Quebec , Canada.
J Trauma Dissociation. 2014;15(1):91-107. doi: 10.1080/15299732.2013.834860.
This study examined the validity of dissociative schizophrenia diagnostic criteria. In the first phase, 50 participants with a psychotic disorder were administered the Dissociative Experiences Scale and the Childhood Trauma Questionnaire to identify those with dissociative characteristics. In the second phase, we selected those who had a score of 15 or above on the Dissociative Experiences Scale. Fifteen of these participants were evaluated thoroughly with the Structured Clinical Interview for DSM-IV Axis I, Structured Clinical Interview for DSM-IV Axis II, and Structured Clinical Interview for DSM-IV Dissociative Disorders to determine whether they met the criteria for dissociative schizophrenia and to generate a clinical description. Our results indicated that 24% of the individuals we tested met these criteria. We propose making mandatory 1 of the 3 dissociative symptoms of the criteria to eliminate people with only nonspecific symptoms (e.g., extensive comorbidity). According to this modified criterion, 14% of our sample would receive a diagnosis of dissociative schizophrenia. However, a more comprehensive look at the clinical picture begs the question of whether dissociative schizophrenia is truly present in every person meeting the criteria. We discuss the relevance of creating a new schizophrenia subtype and offer recommendations for clinicians.
本研究旨在检验分裂样精神病的诊断标准的有效性。在第一阶段，对 50 名患有精神障碍的参与者进行了分离体验量表和儿童创伤问卷的评估，以确定具有分离特征的个体。在第二阶段，我们选择了那些在分离体验量表上得分达到 15 或以上的个体。其中 15 名参与者接受了 DSM-IV 轴 I 结构性临床访谈、DSM-IV 轴 II 结构性临床访谈和 DSM-IV 分离性障碍结构性临床访谈的全面评估，以确定他们是否符合分裂样精神病的标准，并生成临床描述。我们的结果表明，我们测试的个体中有 24%符合这些标准。我们建议将标准中的 3 种分离症状中的 1 种作为强制性要求，以排除仅有非特异性症状的人（例如，广泛共病）。根据这个修改后的标准，我们的样本中有 14%会被诊断为分裂样精神病。然而，更全面地观察临床情况引发了一个问题，即是否每个符合标准的人都真正存在分裂样精神病。我们讨论了创建新的精神分裂症亚型的相关性，并为临床医生提供了建议。
