Traumatic and dissociative experiences in a sample of patients with schizophrenia and bipolar disorder Simões, S., Espírito-Santo, H., Jesus, M., & Marques, M. Instituto Superior Miguel Torga | Research & Development Department | Coimbra | Portugal References 1. Janssen I, Krabbendam L, Bak M et al. Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatr Scand. 2004; 109: 38–45 2. Read J. Child abuse and psychosis: a literature review and implications for professional practice. Prof Psychol Res Pr. 1997; 28:448–56 3. Ellason JW, Ross CA, Fuchs DL. Lifetime axis I and II comorbility and childhood trauma history in dissociative identity disorder. Psychiatry. 1996; 59(3): 255–66. 4. Moskowitz AK, Barker-Collo S, Ellson L. Replication of Dissociation-Psychosis Link in New Zealand Students and Inmates. J Nerv Ment Dis. 2005 Nov;193(11):722–7. 5. Näring G, Nijenhuis ERS. Relationships between self-reported potentially traumatizing events, psychoform and somatoform dissociation, and absorption, in two non-clinical populations. Aust NZ J Psychiatry. 2005 Nov 23;39:982–8. 6. Mulder RT, Beautrais AL, Joyce PR, Fergusson DM. Relationship between dissociation, childhood sexual abuse, childhood physical abuse, and mental illness in a general population sample. Am J Psychiatry. 1998 Jun 18;155(6):806–11. 7. Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis. 1986;174(12):727–35. 8. Espirito-Santo H, Abreu JLP. Portuguese Validation of the Dissociative Experiences Scale (DES). J Trauma Dissociation. 2009 Jan;10(1):69–82. 9. Nijenhuis E, van der Hart O, Kruger K. The psychometric characteristics of the Traumatic Experiences Checklist (TEC): first findings among psychiatric outpatients. Clin Psychol Psychother. 2002;9:200–10. 10.Espirito-Santo H, Rocha P, Gonçalves L, Cassimo S, Martins L, Xavier M. The portuguese traumatic experiences checklist (TEC): psychometrics and prevalence of traumatic experiences. Eur Psychiatry. 2013 Jan;28(Supl. 1). 11.Amorim P. Mini International Neuropsychiatric Interview (MINI): validation of a short structured diagnostic psychiatric interview. Rev Bras Psiquiatria. 2000;22(3):106–15. Conclusions ✦ Many schizophrenic and bipolar Portuguese patients dissociate and had traumatic experiences in childhood, which is supported by the literature. ✦ Given the importance of these results, it is necessary to replicate with bigger samples, and compare the two disorders to draw more conclusive interpretations. ✦ Nevertheless, therapeutic interventions should consider these aspects. Methods ✦ The sample included 30 patients (M ± SD age = 42.6 ± 12.38; range 20-65 years) with Schizophrenia (n = 22) and Bipolar Disorder (n = 8) from a mentally ill home. Seven were women and 23 were men with a mean formal education years of 9.00 (SD = 3.94), mostly without a partner (83.3%). ✦ Assessment included: • Dissociative Experiences Scale (DES) [7,8] — 28-item measure of self-response based on the DSM characterization of dissociation, aiming to assess dissociative experiences. It assesses four dimensions: Absorption, Distractibility, Disturbed Memory, and Depersonalization. • Traumatic Experiences Checklist (TEC) [9,10]— covers 29 traumatic experiences, evaluating the presence or absence, the age of occurrence, and the duration and impact of the traumatic experience. Traumatic experiences are divided by types of trauma (e.g. emotional neglect, emotional abuse, physical abuse, corporal threat, sexual harassment, sexual abuse), being possible to calculate the severity of the various types of trauma. • Mini International Neuropsychiatric Interview [11] — Is a structured interview used to confirm the diagnosis of psychopathology. Introduction Background Studies show an association between different traumatic experiences (physical and/ or sexual) and psychotic symptoms [ disorder might have its origin in post-traumatic stress [ dissociation is associated both with psychotic and affective disorders [ Considering simultaneously traumatic experiences and dissociation, these experiences are a decisive factor for the manifestation of dissociative symptoms [6] and, in turn, dissociative symptoms are often part of severe psychopathology. Objectives Given the lack of research in Portugal examining dissociation and trauma in patients with Schizophrenia and Bipolar Disorders, our aims are: to determine if these patients dissociate and what kind of traumatic experiences they had; to analyze association between dissociation and trauma; and check if sociodemographic variables play any role in dissociation or trauma. Results ✦ The total sample had high levels of dissociation (M ± SD = 26.79 ± 15.40) with 12 patients (40%) revealing pathological dissociation (DES > 30). ✦ Patients scored higher in DES absorption factor (M ± SD = 33.52 ± 17.74), followed by distractibility (M ± SD = 29.43 ± 16.82), disturbed memory (M ± SD = 22.56 ± 17.98), and depersonalization (M ± SD = 20.14 ± 18.33). ✦ The number of total traumatic experiences were high (M ± SD = 5.60 ± 2.98), with patients having had more traumatic experiences between 7-12 years of age. ✦ There were no differences between schizophrenic and bipolar patients in any trauma types (p > 0.05). ✦ Significantly, women had more dissociation and traumatic experiences (M ± SD = 36.89 ± 14.09; 7.71 ± 3.68) than men (M ± SD = 23.71 ± 14.70; 2.48 ± 0.51). Married patients had significantly more traumatic experiences (M ± SD = 9.20 ± 2.49). ✦ Dissociation correlated moderately with traumatic experiences ( = 0.40), specially body threat. ✦ TEC and DES were not correlated with age or years of education. Total DES Absorption Distractibility Disturbed Memory Depersonalization TEC Total Body Threat Emotional Abuse Emotional Neglect Sexual Abuse Sexual Arassment 0.40* 0.12 0,37* 0.42* 0.45* 0.63** 0,31 0.49** 0.63** 0.52** 0.03 0.00 0.13 0.06 -0.07 0.06 0.00 0.06 0.09 0.19 0.07 0.00 0.14 0.11 0.10 0.14 0.06 0.20 0.13 0.17 *p < 0.05; **p < 0.01 Differences between disorders DES TEC Schizophrenia Bipolar Correlations between Traumatic Experiences and Dissociation GABINETE DE APOIO PSICOLÓGICO