A Chaotic Mind: What’s All The Commotion with Dissociation
Thursday, May 8, 2025
During the 2025 NEI Spring Congress, Dr. Thomas Schwartz explored the complexities of dissociative disorders in a highly anticipated new session. This talk examined the poor diagnosis rate of dissociative disorders including challenges of accurate diagnosis, their prevalence in specific patient populations, and the underlying neurobiology of dissociation.
Spring Congress attendees gained insights into the evolving landscape of dissociative disorder recognition and management. Dissociative disorders are reported to be present in 1.0-2.5% of the general population on average, but some studies report rates as high as 11.4% in specific non-clinical populations. Prevalence can be significantly higher in psychiatric and clinical populations, potentially reaching 30-43%. Despite this, dissociative disorders are severely underdiagnosed. Dr. Schwartz examined the poor diagnosis rate of dissociative disorders, including challenges of accurate diagnosis.
In true NEI fashion, Dr. Schwartz presented the underlying neurobiology of dissociation and the mechanisms by which treatments may work. Psychotherapy was highlighted as the cornerstone and first-line treatment for most dissociative disorders. Common psychotherapeutic approaches include individual therapy, CBT (often used for comorbid conditions), supportive therapy, and hypnotherapy (caution advised). Pharmacologic interventions were discussed, primarily targeting symptoms or symptom clusters, as no medications are currently FDA-approved for any of the dissociative disorders. Dr. Schwartz covered the most common psychopharmacological approaches in clinical practice. Emerging treatments like rTMS targeting the temporal-parietal junction (TPJ) or ventrolateral prefrontal cortex (VLPFC) have shown some reduction in depersonalization symptoms in preliminary studies but needing further follow-up.
Overall, the session aimed to address the significant issue of underdiagnosis, describe the underlying mechanisms, and discuss current and emerging treatment strategies for dissociative disorders.
The recording of this presentation, as well as all of the presentations from 2025 NEI Spring Congress, will be made available on the NEI website as Encore Presentations for NEI Members.
Source:
Thomas Schwartz, MD. A Chaotic Mind: What’s All The Commotion with Dissociation. Presented May 8 at 2025 NEI Spring Congress, Philadelphia, PA.