Personality, attachment, and dissociation – A study of clinical characteristics in dissociative conversion disorders

ABSTRACT Background: Dissociative conversion disorders involve problems with memory, identity, emotion, perception, behavior, and sense of self. Dissociative symptoms can potentially disrupt psychological, social, and daily life functioning. It is clinically important to evaluate the presence of comorbidities and other characteristics in dissociative disorders which can help in better patient management. Aim: The aim of this study is to assess the clinical characteristics comprising of symptoms, comorbid personality patterns, insight, emotional perception toward their family, and attachment style among patients suffering from dissociative conversion disorder who are attending psychiatry outdoor of a government hospital. Materials and Methods: Sixty patients were selected from the psychiatry outpatient department diagnosed according to the International Classification of Diseases, Tenth Revision and the scales (Dissociative Disorders Interview Schedule, Beck Insight Inventory, Personality Disorder Questionnaire-4, Family Emotional Involvement and Criticism Scale, and Adult Attachment Scale) were administered. Results: Majority of the dissociative patients were found to have somatic complaints and major depressive episodes. In terms of comorbid personality pattern, borderline personality disorder has been found to be the prominent one. Majority of the patients have reported high perceived criticism from their family members, loved ones along with high anxious and avoidant attachment styles. Conclusion: The findings indicate that patients with dissociative conversion disorder need to be interviewed clinically in terms of the comorbidity and underlying psychopathology which will be helpful in the treatment planning. The understanding of the underlying psychological processes will also be helpful for the management in terms of psychotherapy.