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Dissociation as a psychiatric phenomenon
Julkaistu 13.06.2005 10.52
In psychiatric literature, the term dissociation is considered as a psychiatric state (as a disorder or a symptom) or as a psychological defense mechanism against trauma. The concept of dissociation and its association with trauma was first introduced by Pierre Janet (1858–1947), a pupil of Charcot. Some scientists believe that dissociation is a way of organizing information and that it has a critical role in the development of trauma-related psychological problems.
So far dissociative disorders or symptoms have been encountered in patients with various personality disorders, particularly in borderline personality disorder, somatization disorder, eating disorders, alcohol and substance abuse or dependence and in patients with post-traumatic stress disorder. Even some schizophrenic patients manifest several dissociative symptoms. Literature indicates that a substantial number of psychiatric patients have been considered to meet the criteria for a dissociative disorder.
Studies and theories on dissociation and PTSD suggest that some areas of the right hemisphere of the brain are exhibited (by the amygdala) and that there is a reciprocal inhibition of some areas on the left hemisphere (by the orbitofrontal cortex) in response to traumatic experiences. According to another view, the orbitofrontal cortex is involved in the development of the multiple representation of self.
TAPIO LIPSANEN M.D., Ph.D., Satakunta Central Hospital, General Hospital Psychiatry, tapio.lipsanen@satshp.fi
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