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World J Clin Cases. Aug 16, 2014; 2(8): 327-331
Published online Aug 16, 2014. doi: 10.12998/wjcc.v2.i8.327
Dissociative symptoms and dissociative disorders comorbidity in obsessive compulsive disorder: Symptom screening, diagnostic tools and reflections on treatment
Hasan Belli
Hasan Belli, Department of Psychiatry, Bagcılar Education and Research Hospital, Bagcılar, Istanbul 34400, Turkey
Author contributions: Belli H contributed to this paper.
Correspondence to: Hasan Belli, MD, Associate Professor, Department of Psychiatry, Bagcılar Education and Research Hospital, Merkez Mahallesi, Bagcılar, Istanbul 34400, Turkey. hasan.belli@hotmail.com
Telephone: +90-212-4404002 Fax: +90-212-4404000
Received: March 15, 2014
Revised: May 13, 2014
Accepted: June 18, 2014
Published online: August 16, 2014
Processing time: 172 Days and 1.4 Hours
Abstract

Borderline personality disorder, conversion disorder and obsessive compulsive disorder frequently have dissociative symptoms. The literature has demonstrated that the level of dissociation might be correlated with the severity of obsessive compulsive disorder (OCD) and that those not responding to treatment had high dissociative symptoms. The structured clinical interview for DSM-IV dissociative disorders, dissociation questionnaire, somatoform dissociation questionnaire and dissociative experiences scale can be used for screening dissociative symptoms and detecting dissociative disorders in patients with OCD. However, a history of neglect and abuse during childhood is linked to a risk factor in the pathogenesis of dissociative psychopathology in adults. The childhood trauma questionnaire-53 and childhood trauma questionnaire-40 can be used for this purpose. Clinicians should not fail to notice the hidden dissociative symptoms and childhood traumatic experiences in OCD cases with severe symptoms that are resistant to treatment. Symptom screening and diagnostic tools used for this purpose should be known. Knowing how to treat these pathologies in patients who are diagnosed with OCD can be crucial.

Keywords: Dissociation; Obsessive compulsive disorder; Screening and diagnostic tools

Core tip: The literature has demonstrated that the level of dissociation might be correlated with the severity of obsessive compulsive disorder (OCD) and that those not responding to treatment had high dissociative symptoms. The structured clinical interview for DSM-IV dissociative disorders, dissociation questionnaire, somatoform dissociation questionnaire and dissociative experiences scale can be used for screening dissociative symptoms and detecting dissociative disorders in patients with OCD. However, a history of neglect and abuse during childhood is linked to a risk factor in the pathogenesis of dissociative psychopathology in adults. The childhood trauma questionnaire-53 and childhood trauma questionnaire-40 can be used for this purpose.