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Screening for dissociative disorders in psychiatric out- and day care-patients


Mueller-Pfeiffer, Christoph; Rufibach, Kaspar; Wyss, Daniela; Perron, Noelle; Pitman, Roger K; Rufer, Michael (2013). Screening for dissociative disorders in psychiatric out- and day care-patients. Journal of Psychopathology and Behavioral Assessment, 35(4):592-602.

Abstract

Dissociative disorders are frequent and clinically relevant conditions in psychiatric populations. Yet, their recognition in clinical practice is often poor. This study evaluated the performance of three well known and internationally used dissociation scales in screening for dissociative disorders. Consecutively treated out- and day care-patients (n = 160) from several psychiatric units in Switzerland completed the Dissociative Experiences Scale (DES), Somatoform Dissociation Questionnaire (SDQ-20), and Multidimensional Inventory for Dissociation (MID). The Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised (SCID-D-R) was then administered. Test performance of the scales was analyzed by receiver operating characteristic curves. The diagnostic accuracy, represented by the area under the curve, did not differ significantly between the three summary scales. Cut-off scores for detecting at least 80 % of any dissociative disorder and dissociative disorder-not-otherwise-specified/dissociative identity disorder, respectively, were 12 and 20 for the DES, 30 and 33 for the SDQ-20, and 28 and 28 for the MID summary scale. The diagnostic accuracy of the DES subscale ‘absorption’ and the MID subscale ‘somatic symptoms’ was equal or slightly lower than the corresponding summary scale. The DES, SDQ-20, and MID summary scales are suitable in screening for dissociative disorders in general psychiatric out- and day care-patients. Adequate cut-off scores in the German-adapted DES are lower than in non-German versions. Screening with the DES subscale ‘absorption’ and the MID subscale ‘somatic symptoms’ could be more efficient without the loss of diagnostic accuracy.

Abstract

Dissociative disorders are frequent and clinically relevant conditions in psychiatric populations. Yet, their recognition in clinical practice is often poor. This study evaluated the performance of three well known and internationally used dissociation scales in screening for dissociative disorders. Consecutively treated out- and day care-patients (n = 160) from several psychiatric units in Switzerland completed the Dissociative Experiences Scale (DES), Somatoform Dissociation Questionnaire (SDQ-20), and Multidimensional Inventory for Dissociation (MID). The Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised (SCID-D-R) was then administered. Test performance of the scales was analyzed by receiver operating characteristic curves. The diagnostic accuracy, represented by the area under the curve, did not differ significantly between the three summary scales. Cut-off scores for detecting at least 80 % of any dissociative disorder and dissociative disorder-not-otherwise-specified/dissociative identity disorder, respectively, were 12 and 20 for the DES, 30 and 33 for the SDQ-20, and 28 and 28 for the MID summary scale. The diagnostic accuracy of the DES subscale ‘absorption’ and the MID subscale ‘somatic symptoms’ was equal or slightly lower than the corresponding summary scale. The DES, SDQ-20, and MID summary scales are suitable in screening for dissociative disorders in general psychiatric out- and day care-patients. Adequate cut-off scores in the German-adapted DES are lower than in non-German versions. Screening with the DES subscale ‘absorption’ and the MID subscale ‘somatic symptoms’ could be more efficient without the loss of diagnostic accuracy.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Klinik für Konsiliarpsychiatrie und Psychosomatik
04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:16 Aug 2013 14:57
Last Modified:07 Dec 2017 22:00
Publisher:Springer
ISSN:0882-2689
Additional Information:The final publication is available at link.springer.com
Publisher DOI:https://doi.org/10.1007/s10862-013-9367-0

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