Dissociative Disorders & Unipolar Mood Disorder

Q: What defines Dissociative Disorders?

A: Severe disruptions in identity, memory, and consciousness beyond one’s control.

Q: What is dissociation?

A: Lack of normal integration of thoughts, feelings, and experiences in consciousness and memory.

Q: Name the main Dissociative Disorders.

A: Dissociative Amnesia (with/without Fugue), Depersonalization/Derealization Disorder, Dissociative Identity Disorder (DID).

Q: Subtypes of Dissociative Amnesia?

• Generalized: Forget everything, including identity.

• Localized: Forget specific traumatic events.

• Fugue: Amnesia + sudden travel.

Q: DSM-5 criteria for Dissociative Amnesia?

• Inability to recall important autobiographical info (traumatic/stressful).

• Causes distress/impairment.

• Not due to substances or medical condition.

• Not better explained by other disorders.

• Specifier: With fugue (purposeful travel + identity amnesia).

Q: Define depersonalization vs. derealization.

• Depersonalization: Feeling detached from self (outside observer).

• Derealization: Feeling external world is unreal.

Q: Key features of depersonaliza/derealization disorders?

• Persistent/recurrent episodes.

• Reality testing intact.

• Causes distress/impairment.

• Not due to substances or other disorders.

Q: Associated deficits with deperso?

Q: What is DID - dissociative identity disorder?

Presence of two or more distinct identities (alters) with discontinuity in sense of self and recurrent memory gaps.

Characteristics of DID?

A:

• Host identity seeks treatment.

• Alters have distinct traits.

• Switch between identities is sudden.

• Average 15 alters.

• Childhood onset.

Etiology of DID?

A:

• Posttraumatic model (childhood abuse).

• Suggestibility/autohypnotic coping.

• Possible therapy-induced cases.

• Biological factors: temporal lobe involvement, sleep deprivation.

Q: Treatment for DID?

A: Long-term psychotherapy to integrate identities (success rate ~22%).

Q: What are Unipolar Mood Disorders?

A: Disorders involving only depressive episodes (no mania).

Q: DSM-5 criteria for MDD?

A:

• ≥5 symptoms for ≥2 weeks (must include depressed mood or anhedonia).

• Symptoms: sleep/appetite changes, fatigue, guilt, poor concentration, suicidal thoughts.

• Causes distress/impairment.

• No manic/hypomanic episodes.

Q: Average duration of untreated first episode?

A: ~9 months.

Q: Key features of PDD?

A:

• Chronic depression ≥2 years (≥1 year in children).

• Symptoms less severe than MDD but longer duration.

• Higher comorbidity and suicide risk.

• Poor treatment response.

Q: DSM-5 criteria for PDD?

A:

• Depressed mood most of the day for ≥2 years.

• ≥2 symptoms: poor appetite, insomnia/hypersomnia, low energy, low self-esteem, poor concentration, hopelessness.

• Never symptom-free >2 months.

Q: Common specifiers for depressive disorders?

A: Psychotic, anxious distress, mixed, melancholic, atypical, catatonic, peripartum onset, seasonal pattern.

Q: Prevalence of MDD and PDD?

A:

• MDD: 7–11.3% in Canada.

• PDD: ~2.5%.

Q: Gender differences for MDD & PDD?

A: Women twice as likely as men.

Q: Common treatments for depressive disorders?

A: CBT, antidepressants, interpersonal therapy, ECT for severe cases.