Dissociative processes and symptoms of schizophrenia spectrum disorders

Monika ZWIRSKA¹, Artur DAREN¹, Aneta KALISZ¹, Piotr B??DZI?SKI¹, Andrzej CECHNICKI¹

¹University Hospital in Cracow, Association for the Development of Community Psychiatry and Care, Kraków, Poland

Introduction

In recent years, it has been recognized that dissociative processes are an important factor in the etiology and treatment of this type of disorder. These processes can be further divided into two types: fragmentation and detachment. The primary objective of our study is to analyze the relationships between the severity of dissociative symptoms and the symptomatology of schizophrenia spectrum disorders, cognitive functioning and mindful awareness.

Materials and methods

The study involved 70 patients with a diagnosis of schizophrenia spectrum disorder . Participants were examined with the Positive and Negative Syndrome Scale (PANSS), The Addenbrooke's Cognitive Examination-III (ACE-III), Audit-C, Anxiety and Depression Scale (DASS-14), Mindful Attention Awareness Scale (MAAS), Dissociative Experiences Scale Revised (DES-R), Somatoform Dissociation Questionnaire (SDQ 20), Detachment and Compartmentalization Inventory (DCI), Dissociative Symptoms Scale (DSS).

Results

The participants showed various intensity of dissociative processes, with 18.6% reaching the cut-off of 28 points for dissociation in SDQ-20 and 32.9% the cut-off of 72 points in DES-R. The strongest correlations were found for dissociative symptoms and symptoms of depression, anxiety and emotional distress. Weaker correlations emerged between some positive symptoms and dissociative symptoms. The strongest inverse correlation was found for mindful awareness and dissociative symptoms. A linear regression model including number of stationary hospitalizations, anxiety and depression symptoms, duration of illness (years), cognitive functioning (ACE=III) as covariates (all non-significant) and dissociation symptoms (DSS; significant) explained 24% of variance in psychopathological symptoms (PANSS).

Conclusion

The study showed that a significant portion of patients experiencing schizophrenic symptoms also experience marked dissociative symptoms, which indicates potential direction for further research and the design of therapeutic approaches to effectively help people experiencing psychotic symptoms. The study also showed that mindfulness techniques could facilitate the therapeutic process as regards dissociative as well as depressive, anxiety and emotional withdrawal symptoms.