Boyer Stacey M, Caplan Jennifer E, Edwards Lisa K
Director, Psychology Services, Outpatient and Embedded Behavioral Health, ChristianaCare.
Widener University Institute for Graduate Clinical Psychology.
Dela J Public Health. 2022 May 31;8(2):78-84. doi: 10.32481/djph.2022.05.010. eCollection 2022 May.
Trauma-related dissociation is a major public health risk warranting the attention of the healthcare professions. Severe dissociative pathology or dissociative disorders (DDs) are more prevalent than some commonly assessed psychiatric disorders (e.g., Bipolar Disorder, Obsessive Compulsive Disorder, Schizophrenia), yet are often under-recognized and undertreated, despite being associated with significant disability and chronic medical issues, among many other severe and costly public health consequences. In fact, people living with DDs spend an average of 5 to 12.4 years actively engaged in treatment before receiving an accurate diagnosis. Detection and treatment of trauma-related dissociation and DDs leads to a myriad of positive outcomes including improved quality of life, treatment outcomes, reduction in health and social risks, decreased healthcare utilization and costs (25-64% reduction), and significant economic advantages for society. It is imperative that healthcare professionals are trained in recognizing, assessing, and treating dissociation in service of preventing the discussed public health consequences. This article provides a comprehensive review of the important public health implications resulting from often neglected or untreated trauma-related dissociation and DDs while offering a summary of assessment methods, treatments, and resources to empower individuals and healthcare professionals to effect change.
创伤相关的分离是一个重大的公共卫生风险，值得医疗行业关注。严重的分离性病理状态或分离性障碍（DDs）比一些常见的评估精神障碍（如双相情感障碍、强迫症、精神分裂症）更为普遍，但尽管与严重残疾和慢性医疗问题以及许多其他严重且代价高昂的公共卫生后果相关，却常常未得到充分认识和治疗。事实上，患有分离性障碍的人在获得准确诊断之前，平均要花费5到12.4年积极接受治疗。对创伤相关的分离和分离性障碍进行检测和治疗会带来众多积极成果，包括提高生活质量、改善治疗效果、降低健康和社会风险、减少医疗保健利用和成本（降低25 - 64%）以及为社会带来显著的经济优势。医疗专业人员必须接受培训，以识别、评估和治疗分离，从而预防上述公共卫生后果。本文全面回顾了因常常被忽视或未治疗的创伤相关分离和分离性障碍所产生的重要公共卫生影响，同时总结了评估方法、治疗方法和资源，以增强个人和医疗专业人员实现改变的能力。
