Dissociative Psychosis: Clinical and Theoretical Aspects

This chapter describes the features of dissociative schizophrenia and the clinical model and research data supporting its existence. In classical dissociative identity disorder (DID), the characteristic symptoms are due to full switches of executive control between highly structured, personified, and discrete ego states, or alter personalities. Typically, even in DID, much of the personality system is often structured and functions at the level of Other Specified Dissociative Disorder (OSDD). Dissociative schizophrenia fits into broader conception of dissociative disorders, as do the Schneiderian first-rank symptoms of schizophrenia. The clinical implications of dissociative schizophrenia are the following: dissociative symptoms are common in schizophrenia and must be considered in treatment, some cases of schizophrenia may be treatable with psychotherapy, the environment can be the major aetiological factor in many cases of schizophrenia, and psychological trauma is a major theme in schizophrenia.