Iskanderova Rinata, Vasilyev Valeriy V
Izhevsk State Medical Academy, Izhevsk, Russia.
Psychol Russ. 2021 Jun 30;14(2):3-14. doi: 10.11621/pir2021.0201. eCollection 2021.
Dissociation is a generally recognized phenomenon in psychology and psychiatry; however, questions are still not fully resolved about the difference between pathological and normal dissociation, as well as the role of dissociation, depending on its aetiology, in the formation of clinical manifestations of mental disorders.
To complement the existing data about the significance of dissociation in non-psychotic mental disorders.
Using the Dissociative Experience Scale (DES), we screened 62 patients (13 male and 49 female) from the Non-Psychotic Conditions Inpatient Department of the Udmurt Republican Clinical Psychiatric Hospital (Izhevsk, Russia). Nineteen of the patients had mental disorders of organic aetiology and 43 patients had mental disorders of psychogenic aetiology.
Dissociation at the pathological level was detected in 12.9% of the patients, all of them female. Among patients with psychogenic disorders, the proportion of patients with pathological dissociation was more than three times that of patients with organic disorders. Among the particular dissociative phenomena, absorption had the highest average severity, both in the general sample and in each aetiological group of patients, while dissociative amnesia had the lowest average severity. The highest levels of dissociation were found in young female patients who had never been married. In patients with psychogenic disorders, the average dissociation severity was significantly higher than in the general population, while in patients with organic disorders it was significantly lower.
The dissociation phenomenon may play a significant symptom-forming role in young women suffering from non-psychotic mental disorders of psychogenic aetiology. In the case of organic mental disorders, the severity of dissociative manifestations decreases even below the conditionally normal level, which may indirectly indicate the destruction of dissociative physiological mechanisms by an organic brain process.
分离是心理学和精神病学中普遍公认的现象；然而，关于病理性分离与正常分离之间的差异，以及分离根据其病因在精神障碍临床表现形成中的作用等问题仍未完全解决。
补充关于分离在非精神病性精神障碍中的意义的现有数据。
我们使用分离体验量表（DES）对俄罗斯乌德穆尔特共和国临床精神病医院（伊热夫斯克）非精神病性疾病住院部的62名患者（13名男性和49名女性）进行了筛查。其中19名患者患有器质性病因的精神障碍，43名患者患有心因性病因的精神障碍。
在12.9%的患者中检测到病理性分离，所有这些患者均为女性。在心因性障碍患者中，病理性分离患者的比例是器质性障碍患者的三倍多。在特定的分离现象中，无论是在总体样本还是在各病因组患者中，专注的平均严重程度最高，而分离性遗忘的平均严重程度最低。从未结婚的年轻女性患者的分离水平最高。在心因性障碍患者中，分离的平均严重程度显著高于一般人群，而在器质性障碍患者中则显著低于一般人群。
分离现象可能在患有心因性病因的非精神病性精神障碍的年轻女性中起重要的症状形成作用。在器质性精神障碍的情况下，分离表现的严重程度甚至降至条件正常水平以下，这可能间接表明有机脑过程对分离生理机制的破坏。
