Dissociative Disorders (A Deep Dive)

Hello, everybody. In this video, we're going to be discussing dissociative disorders. As always on our YouTube channel, we have a whole playlist for the USMLE Step 1 videos, and I highly recommend you watch the psychiatry playlist in sequential order. This will give you everything you need for the Step 1 psych portion. Don't forget to like, comment, and subscribe to the channel. Now, let's talk about dissociative disorders. Dissociative disorders are conditions that involve a disruption to a patient's memory, awareness, identity, or perception. These four criteria - memory, awareness, identity, perception - allow us to realize where we are and who we are. They allow us to stay attached and not dissociate ourselves from who, what, when, and where we are. Dissociative conditions or disorders do the exact opposite; they help individuals disassociate. There are four main dissociative conditions: depersonalization or derealization disorder, dissociative identity disorder, dissociative amnesia, and dissociative fugue. All four of these disorders can occur during or after a stressful event. For example, someone who has gone through a traumatic experience like sexual assault might have a lot of these disorders all at once. Let's start discussing the actual dissociative disorders themselves, beginning with depersonalization or derealization disorder. In this disorder, a patient has persistent feelings of detachment or estrangement from one's body, thoughts, or from the environment. These patients have intact reality testing, which differentiates this disorder from psychosis. In psychosis, patients lose touch with reality. In the depersonalization portion of this disorder, patients may describe having a third-person view of themselves. In the derealization portion, patients feel detached from the surrounding world. Next, we have the dissociative identity disorder, more commonly known as multiple personality disorder. This disorder is more common in women and is usually associated with childhood trauma and abuse, especially sexual abuse. It's also associated with PTSD, depression, substance abuse, borderline personality disorder, and somatoform conditions. The presence of two or more distinct identities or personality states is a key hallmark of this disorder. The third disorder is dissociative amnesia, also known as psychological amnesia. In this condition, the patient cannot recall important personal information that cannot be explained by another cause. This is usually subsequent to severe trauma or stress. Patients are not able to recall autobiographic memories or past events. However, this type of amnesia is potentially reversible through therapy. Finally, we have dissociative fugue, a subtype of dissociative amnesia. This refers to a state of bewildering wandering. Patients with dissociative amnesia may suddenly end up traveling or wandering while they're dissociated. The onset of the fugue is usually sudden and follows a traumatic event. The treatment for all these disorders is therapy, specifically cognitive behavioral and general psychotherapy. Don't forget to like, comment, and subscribe to the channel, and watch the psychiatry playlist that's posted on the channel. I'll see you guys soon. Go ahead and move on to the next video.