Dissociative experiences in patients with epilepsy Experiências dissociativas em pacientes com epilepsia

Dissociative disorders are characterized by a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior1. Dissociative experiences occur on a continuum ranging from the minor or normative dissociative states such as absorbtion or daydreaming customary to daily life to pathological states such as dissociative identity disorder2. The prevalence rates has varied from a low of 1.0% to a high of 12.8% depending on the cut-off point indicative of pathological dissociative symptomatology3,4. The Dissociative Experience Scale (DES) is the most widely used standard screening tool utilized for assessing dissociative symptoms3,4,5. The strong linkages of dissociation to childhood emotional, physical or sexual trauma have long been recognized. Dissociation is considered to serve as a defense mechanism againts intolerable, trauma-associated memories and feelings4. Despite dissociative disorders are conceptualized in a separate spectrum, pathological dissociation has been demonstrated to be higly co-occurring condition with mental disorders including posttraumatic stress disorder, borderline personality disorders, anxiety and mood disorders, and substance use disorder4. Dissociative experiences can also be observed in different types of brain pathology such as epilepsy, head injuiry, tumor, encephalitis and intoxication6,7.