Polysymptomatic clinical charastheristics of adolescents with dissociative disorder and the role of dissociation over suicide and self mutilation development

ABSTRACTPOLYSYMTOMATIC CLINICAL CHARACTERISTICS OF ADOLESCENTSWITH DISSOCIATIVE DISORDER AND THE ROLE OF DISSOCIATION OVERSUICIDE AND SELF-MUTILATION DEVELOPMENTDr.Filiz KILICResidency thesis, Department of Child and Adolescent PsychiatrySupervisor: S. Salih ZOROGLU, M.D. Associate ProfessorSeptember 2006, 87 pagesDissociative disorders are an important disease category withpolysymptomatic prognosis, presented with etiology of childhood traumas whichcould be recognized in childhood and adolescence period only in 10-11% ofcases. Trauma, self-mutilation and suicidal attempts are reported to have arelation with regard to dissociation levels in certain studies. The aim of thisstudy was: a) to reveal the psychiatric common symptoms of adolescents withdissociative disorder diagnosed with a semi-structured scale and to show that itis a disorder with polysymptomatic prognosis by comparing those with otheradolescents having a psychiatric disorder, b) to exhibit the roles andcontributions of dissociation, dissociative disorder, trauma and other relatedcases over self-mutilative and suicidal behaviour development.In the present study, the groups with dissociative disorder, depression,anxiety disorder and a healthy group, were compared with each other.Trauma rates in patients with dissociative disorder was determined to behigher than the other patient groups and healthy controls. Depression andanxiety symptoms in the dissociative group was observed to be as high asthose of patients with depression and anxiety disorder. Self mutilation (80.8%)and suicidal behaviour (65.4%) rates were found to be significantly higher in thegroup of dissociative disorder compared to the other groups.Apparently, adolescents with dissociative disorder exhibit commonsymptoms and the prognose of the disease is observed to be polysymptomaticespecially in adolescents. Thus, the life period in which the most evidentsymptoms of dissociative disorder are observed, seems to be adulthood.Elevated dissociation as a result of logistic regression, is seen to be the mainmediator of the process starting with trauma and ending with associatedpsychopathology. Seperately, dissociation and dissociative disorder are themost influencing factors in development of self mutilation.Keywords: Dissociative disorder, Trauma, Self-mutilation, Suicidal attempt