From the Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Germany; the Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; the Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario; and the Department of Health, Antwerp University, Antwerp, Belgium.
Am J Psychiatry. 2018 Jan 1;175(1):37-46. doi: 10.1176/appi.ajp.2017.17010025. Epub 2017 Sep 26.
Dissociation is a complex, ubiquitous construct in psychopathology. Symptoms of dissociation are present in a variety of mental disorders and have been connected to higher burden of illness and poorer treatment response, and not only in disorders with high levels of dissociation. This meta-analysis offers a systematic and evidence-based study of the prevalence and distribution of dissociation, as assessed by the Dissociative Experiences Scale, within different categories of mental disorders, and it updates an earlier meta-analysis.
More than 1,900 original publications were screened, and 216 were included in the meta-analysis, comprising 15,219 individuals in 19 diagnostic categories.
The largest mean dissociation scores were found in dissociative disorders (mean scores >35), followed by posttraumatic stress disorder, borderline personality disorder, and conversion disorder (mean scores >25). Somatic symptom disorder, substance-related and addictive disorders, feeding and eating disorders, schizophrenia, anxiety disorder, OCD, and most affective disorders also showed mean dissociation scores >15. Bipolar disorders yielded the lowest dissociation scores (mean score, 14.8).
The findings underline the importance of careful psychopathological assessment of dissociative symptoms in the entire range of mental disorders.
分离是精神病理学中一种复杂且普遍存在的结构。分离症状存在于多种精神障碍中，并与更高的疾病负担和更差的治疗反应有关，而不仅仅存在于分离程度较高的障碍中。本荟萃分析对通过分离体验量表评估的不同精神障碍类别中的分离症的患病率和分布进行了系统的、基于证据的研究，并更新了早期的荟萃分析。
筛选了 1900 多篇原始出版物，其中 216 篇被纳入荟萃分析，包括 19 个诊断类别的 15219 个人。
分离症的平均分离评分最高（平均评分>35），其次是创伤后应激障碍、边缘型人格障碍和转换障碍（平均评分>25）。躯体症状障碍、物质相关和成瘾障碍、进食和饮食障碍、精神分裂症、焦虑症、强迫症和大多数情感障碍也显示出平均分离评分>15。双相情感障碍的分离评分最低（平均评分 14.8）。
这些发现强调了在整个精神障碍范围内仔细进行分离症状的精神病理学评估的重要性。
