High psychiatric comorbidity in adolescents with dissociative disorders.
OBJECTIVE
The aim of this study was to evaluate psychiatric comorbidity rates and patterns in a sample of clinically referred adolescents diagnosed with dissociative disorders (DD) by using a structured interview.


METHODS
All participants completed a comprehensive test battery, which consisted of a questionnaire for sociodemographic data and clinical history, Child Posttraumatic Stress Reaction Index, Childhood Abuse and Neglect Questionnaire and the Adolescent Dissociative Experiences Scale. Diagnosis was made by the Structured Clinical Interview for DSM-IV Dissociative Disorders. Psychiatric comorbidity was assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime Version.


RESULTS
A total of 25 adolescent subjects aged 12-18 years participated in the study. Ten adolescents were diagnosed as having dissociative identity disorder and 15 of them were diagnosed as having dissociative disorder-not otherwise specified based on the Structured Clinical Interview for DSM-IV Dissociative Disorders findings. Adolescents with dissociative identity disorder were found to have higher scores on the Adolescent Dissociative Experiences Scale and Child Posttraumatic Stress Reaction Index than the dissociative disorder-not otherwise specified group. Sexual and physical abuses were also found to be among the main traumatic events. Incest was reported in six cases of the study sample. All subjects had at least one comorbid psychiatric disorder. The most common psychiatric diagnoses were major depressive disorder (n = 25; 100%) and post-traumatic stress disorder (n = 22; 88%).


CONCLUSIONS
High psychiatric comorbidity rates were found in adolescents diagnosed with DD. A prevalent history of abuse and traumatic events was represented. Clinicians should be aware of the impacts of DD on adolescents' mental health.
Department of Child and Adolescent Psychiatry, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey.
Hasan
H
Bozkurt
Department of Child and Adolescent Psychiatry, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
Tuba
T
Duzman Mutluer
Department of Child and Adolescent Psychiatry, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
Cigdem
C
Kose
Department of Child and Adolescent Psychiatry, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
Salih
S
Zoroglu
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data*; D015331:Cohort Studies; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology*; D004213:Dissociative Disorders / Q000453:epidemiology; D009105:Dissociative Identity Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D010698:Phobic Disorders / Q000453:epidemiology*; D011618:Psychotic Disorders / Q000453:epidemiology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014421:Turkey / Q000453:epidemiology
adolescents; comorbidity; dissociation; psychiatric disorders