Salama Ahmed Z, Dabash Mohammad R, Elayan Abdullah, Saadeh Shafee, Ikhmayyes Ibrahim
School of Medicine, Al-Quds University, Jerusalem, PSE.
Psychiatry, Dr. Kamal Psychiatric Hospital, Bethlehem, PSE.
Cureus. 2024 Dec 27;16(12):e76458. doi: 10.7759/cureus.76458. eCollection 2024 Dec.
Dissociation is a cognitive process that disrupts consciousness, identity, or memory. It is frequently used as a form of defense in response to significant stress or trauma. In serious situations, it might show as a dissociative disorder, which extremely impairs psychological functioning. Dissociative trance, a type of other specified dissociative disorder (OSDD), is characterized by an abrupt loss of awareness, leading to unresponsiveness and involuntary actions. Despite being conscious, the individual may feel separated from their body, as if it were under the control of an external force. This case report represents a 22-year-old patient with no prior criminal history who experienced episodes of decreased consciousness, altered identity, and involuntary movements. These episodes were perceived as being controlled by an external force and culminated in a tragic event leading the patient to kill her children. After ruling out other potential causes like psychotic disorders, organic factors, and substance abuse, a diagnosis of dissociative trance disorder was considered. Treatment with cognitive behavioral therapy, antidepressants, antipsychotics, and benzodiazepines resulted in improvement of the patient's symptoms.
分离是一种扰乱意识、身份或记忆的认知过程。它经常被用作应对重大压力或创伤的一种防御形式。在严重情况下,它可能表现为分离性障碍,这会严重损害心理功能。分离性恍惚是其他特定分离性障碍(OSDD)的一种类型,其特征是意识突然丧失,导致无反应和不自主行为。尽管个体有意识,但可能会感觉自己与身体分离,仿佛身体受外力控制。本病例报告介绍了一名22岁、无犯罪史的患者,她经历了意识下降、身份改变和不自主运动发作。这些发作被认为是受外力控制的,最终导致了一场悲剧事件,患者杀死了自己的孩子。在排除了精神障碍、器质性因素和药物滥用等其他潜在原因后,考虑诊断为分离性恍惚障碍。采用认知行为疗法、抗抑郁药、抗精神病药和苯二氮䓬类药物治疗后,患者症状有所改善。