Dissociative disorder

POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal plasma cell disorder, Skin changes) refers to a rare paraneoplastic entity linked to a plasma cell disorder, characterized by multiple systemic manifestations that must be studied together to establish a timely diagnosis. We report a case of a 60-year-old female who had been initially classified to have Guillain Barré syndrome for one year and seven months, receiving three cycles of immunoglobulin without a positive response...

Background: Although peritraumatic dissociation (PD) is viewed as a risk factor for posttraumatic stress disorder (PTSD), prospective studies taking into account other well-known risk factors for PTSD have been scarce, and the exploration of potential moderators within the relations between PD and PTSD has been lacking. Objective: Filling this gap, this prospective study explored the moderating role of perceived threat within the relations between PD and PTSD, above and beyond age, gender, education, and early trauma-related symptoms...

Stress has been considered as a major risk factor for depressive disorders, triggering depression onset via inducing persistent dysfunctions in specialized brain regions and neural circuits. Among various regions across the brain, the lateral habenula (LHb) serves as a critical hub for processing aversive information during the dynamic process of stress accumulation, thus having been implicated in the pathogenesis of depression. LHb neurons integrate aversive valence conveyed by distinct upstream inputs, many of which selectively innervate the medial part (LHbM) or lateral part (LHbL) of LHb...

The past decade has witnessed amplified public awareness of age-related dementias. This has resulted in a dramatic rise in the number of older persons referred to memory clinics with a primary complaint of self-reported memory loss without an antecedent neurological event (e.g., stroke) who produce neuropsychological test profiles that lack evidence of such impairment. Since the latter part of the 19th century, a confusing array of changing terminology, criteria, and perceived causation have been ascribed to patients with unverified medical symptoms to implicate psychological causation...

Identifying and contrasting different patterns of intimate partner violence (IPV) (e.g. situational couple violence, coercive controlling violence) is useful for understanding IPV and its connections with health. Applying this approach to dissociation may be fruitful, given theoretical perspectives that predict a specific connection between coercive controlling violence and dissociative symptoms. To address this, community women with divorce histories ( N  = 188) completed measures to identify patterns of IPV victimization in prior relationships (no direct violence, situational couple violence, coercive controlling violence), and to quantify recent dissociative symptoms and number of depressed days, for comparison...

Neonatal opioid withdrawal syndrome (NOWS) is a growing public health concern. The complexity of in utero opioid exposure in clinical studies makes it difficult to investigate underlying mechanisms that could ultimately inform early diagnosis and treatments. Clinical studies are unable to dissociate the influence of maternal polypharmacy or the environment from direct effects of in utero opioid exposure, highlighting the need for effective animal models. Early animal models of prenatal opioid exposure primarily used the prototypical opioid, morphine, and opioid exposure that was often limited to a narrow period during gestation...

BACKGROUND: Identifying covert consciousness in intensive care unit (ICU) patients with coma and other disorders of consciousness (DoC) is crucial for treatment decisions, but sensitive low-cost bedside markers are missing. We investigated whether automated pupillometry combined with passive and active cognitive paradigms can detect residual consciousness in ICU patients with DoC. METHODS: We prospectively enrolled clinically low-response or unresponsive patients with traumatic or nontraumatic DoC from ICUs of a tertiary referral center...

Cognitive motor dissociation (CMD) is characterized by a dissociation between volitional brain responses and motor control, detectable only through techniques such as electroencephalography (EEG) and functional magnetic resonance imaging. Hence, it has recently emerged as a major challenge in the assessment of patients with disorders of consciousness. Specifically, this review focuses on the prognostic implications of CMD detection during the acute stage of brain injury. CMD patients were identified in each diagnostic category (coma, unresponsive wakefulness syndrome/vegetative state, minimally conscious state minus) with a relatively similar prevalence of around 20%...

PURPOSE OF REVIEW: Physical pain is an underrecognized area of dysregulation among those with borderline personality disorder (BPD). Disturbances are observed within the experience of acute, chronic, and everyday physical pain experiences for people with BPD. We aimed to synthesize research findings on multiple areas of dysregulation in BPD in order to highlight potential mechanisms underlying the association between BPD and physical pain dysregulation. RECENT FINDINGS: Potential biological mechanisms include altered neural responses to painful stimuli within cognitive-affective regions of the brain, as well as potentially low basal levels of endogenous opioids...

Prolonged incest, where children are sexually abused by familial perpetrators into adulthood, has been documented in clinical and criminological scholarship, however it is often overlooked in research, policy and practice approaches to familial sexual abuse. This article draws on interviews with ten Australian therapists about their clinical work with clients subject to incestuous abuse continuing into adulthood. It outlines their descriptions of these cases, the nature of the reported abuse and factors that facilitated prolonged and ongoing incest, including at the time of therapy...

Ganglioside GM1 is a class of glycolipids predominantly located in the nervous system. Comprising a ceramide anchor and an oligosaccharide chain containing sialic acid, GM1 plays a pivotal role in various cellular processes, including signal transduction, cell adhesion, and membrane organization. Moreover, GM1 has been implicated in the pathogenesis of several neurological disorders, such as Parkinson's disease, Alzheimer's disease, and stroke. In this study, by creating a neural cell model membrane simulation system and employing rigorous molecular models, we utilize a coarse-grained molecular dynamics approach to explore the structural and dynamic characteristics of multi-component neuronal plasma membranes at varying GM1 ganglioside concentrations...

BACKGROUND: This study aims to conduct the first-ever evaluation of our previously proposed behaviors of "hemomania" in individuals engaged with nonsuicidal self-injury (NSSI). METHODS: The study encompassed 130 outpatients engaged with NSSI who applied at the psychiatry outpatient clinic. NSSI behaviors were assessed using the Inventory of Statements About Self-Injury, while psychiatric diagnoses were evaluated using the Structured Clinical Interview for DSM-5 Disorders-Clinician Version...

Non-Verbal Learning Disability (NVLD) is a neurodevelopmental disorder characterized by deficits in processing visuospatial information but with age-appropriate verbal skills. This cognitive profile has been hypothesized to be associated with atypical white matter, but at the present there is a lack of evidence for this hypothesis. Currently, the condition is not characterized within the main diagnostic systems, in part because no clear set of criteria for characterizing the disorder exists. This report is the first attempt to estimate NVLD prevalence, using two sets of diagnostic criteria, in a large sample of over 11,000 children who were selected without regards to problems of specific nature, either psychological, neurological, physical and/or social...

Despite a theory that an imbalance in goal-directed versus habitual systems serve as building blocks of compulsions, research has yet to delineate how it occurs during an arbitration process between the two systems in obsessive-compulsive disorder. Inspired by a brain model that the inferior frontal cortex selectively gates the putamen to guide goal-directed or habitual actions, this study aimed to examine whether disruptions in the arbitration process via the fronto-striatal circuit would underlie the imbalanced decision-making and compulsions in patients...

BACKGROUND: Despite the pervasiveness of patient-reported emptiness and the high burden it carries, emptiness is poorly understood. In the current study, we used a general inductive approach to examine experiences with emptiness in a diagnostically diverse sample of treatment-seeking patients with severe and acute psychopathology. As a secondary aim, we also examined whether identified themes differed among patients with a primary diagnosis of borderline personality disorder or major depressive disorder...

Complex posttraumatic stress disorder (CPTSD) is a term representing the psychopathological implications of exposure to chronic, inter-personal trauma. These include the main symptoms of PTSD, as well as changes in identity, emotion regulation, and inter-personal relationships. Self-harm and dissociation (i.e., disintegration of mental processes) are also quite common in CPTSD. Considering this complex and often severe clinical picture, mental health professionals often find it difficult to effectively treat CPTSD...

BACKGROUND AND OBJECTIVE: Guillain-Barre syndrome (GBS) has been found to have some interesting association with vaccinations. This paper mainly focuses on exploring different associations between COVID-19 vaccination and GBS. METHODS: Electronic databases such as PubMed, Google Scholar, Cochrane, and Embase were searched using MESH terms for case reports published till 1 August 2023 from which 70 case reports were documented involving 103 individuals from 23 different countries...

OBJECTIVE: Explore relationships of acute dissociative effects of intravenous ketamine with change in depression and suicidal ideation and with plasma metabolite levels in a randomized, midazolam-controlled trial. METHOD: Data from a completed trial in suicidal, depressed participants (N=40) randomized to ketamine was used to examine relationships between ketamine treatment-emergent dissociative and psychotomimetic symptoms with pre/post-infusion changes in suicidal ideation and depression severity...

BACKGROUND: Electrophysiologic measures provide an opportunity to inform mechanistic models and possibly biomarker prediction of response. Serotonergic psychedelics (SPs) (i.e., psilocybin, lysergic acid diethylamide (LSD)) and ketamine represent new investigational and established treatments in mood disorders respectively. There is a need to better characterize the mechanism of action of these agents. METHODS: We conducted a systematic review investigating the spectral signatures of psilocybin, LSD, and ketamine in persons with major depressive disorder (MDD), treatment-resistant depression (TRD), and healthy controls...

A 63-year-old man with type 2 diabetes mellitus, alcohol consumption in moderation, and three episodes of hepatic encephalopathy presented with symmetrical lower limb distal weakness, sensory ataxia, thickened palpable nerves, mood disturbances for seven years, and a family history of schizophreniform disorders. Nerve conduction studies showed demyelinating sensorimotor polyradiculoneuropathy. CSF analysis showed mild albumino-cytological dissociation. MRI brain and lumbosacral plexus showed thickened fifth cranial nerves and lumbosacral roots...