Limited utility of ICD-10 and DSM-IV classification of dissociative and conversion disorders in India

P. J. Alexander, S. Joseph, A. Das

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Studies of psychiatric out-patients from India have found that diagnosis of some of the subcategories of the dissociative and conversion disorders of the ICD and DSM classificatory systems are rarely made in this setting. Moreover, it was found that a significant percentage of patients seen in psychiatric practice may not fit into the defined subcategories of dissociative (conversion) disorders of these systems of classification. We studied the prevalence of various ICD-10 and DSM-IV categories of dissociative (conversion) disorders and our own proposed category of 'brief dissociative stupor' (BDS), among all the in-patients of a psychiatric unit in a general teaching hospital, over a 2-year period. There were 18 patients who fulfilled our criteria for BDS and 18 patients in the second group which included all of the remaining subjects with a diagnosis of any other subcategory of dissociative disorder according to ICD-10. Our analysis revealed that there were no patients with a diagnosis of dissociative amnesia, fugue, stupor, trance and possession disorders or identity disorders. There were significantly more female patients in the BDS group, and they also had significantly more comorbid Axis-I diagnoses and panic attacks. Since 50% of our patients fulfilled the criteria for BDS, there is clearly a need for further studies to establish the prevalence of this subcategory in patients from other centres. The classification of these patients with this phenomenology is problematic. Inclusion of a subcategory of dissociative non-epileptic seizures, instead of dissociative convulsions, should improve the classification of dissociative (conversion) disorders.

Original languageEnglish
Pages (from-to)177-182
Number of pages6
JournalActa Psychiatrica Scandinavica
Volume95
Issue number3
DOIs
Publication statusPublished - 01-01-1997
Externally publishedYes

Fingerprint

Dissociative Disorders
Conversion Disorder
International Classification of Diseases
Diagnostic and Statistical Manual of Mental Disorders
India
Stupor
Psychiatry
Seizures
Amnesia
Panic Disorder
Teaching Hospitals
General Hospitals
Outpatients

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health

Cite this

@article{bcd00c0adc534fb79f95615a23576526,
title = "Limited utility of ICD-10 and DSM-IV classification of dissociative and conversion disorders in India",
abstract = "Studies of psychiatric out-patients from India have found that diagnosis of some of the subcategories of the dissociative and conversion disorders of the ICD and DSM classificatory systems are rarely made in this setting. Moreover, it was found that a significant percentage of patients seen in psychiatric practice may not fit into the defined subcategories of dissociative (conversion) disorders of these systems of classification. We studied the prevalence of various ICD-10 and DSM-IV categories of dissociative (conversion) disorders and our own proposed category of 'brief dissociative stupor' (BDS), among all the in-patients of a psychiatric unit in a general teaching hospital, over a 2-year period. There were 18 patients who fulfilled our criteria for BDS and 18 patients in the second group which included all of the remaining subjects with a diagnosis of any other subcategory of dissociative disorder according to ICD-10. Our analysis revealed that there were no patients with a diagnosis of dissociative amnesia, fugue, stupor, trance and possession disorders or identity disorders. There were significantly more female patients in the BDS group, and they also had significantly more comorbid Axis-I diagnoses and panic attacks. Since 50{\%} of our patients fulfilled the criteria for BDS, there is clearly a need for further studies to establish the prevalence of this subcategory in patients from other centres. The classification of these patients with this phenomenology is problematic. Inclusion of a subcategory of dissociative non-epileptic seizures, instead of dissociative convulsions, should improve the classification of dissociative (conversion) disorders.",
author = "Alexander, {P. J.} and S. Joseph and A. Das",
year = "1997",
month = "1",
day = "1",
doi = "10.1111/j.1600-0447.1997.tb09617.x",
language = "English",
volume = "95",
pages = "177--182",
journal = "Acta Psychiatrica Scandinavica",
issn = "0001-690X",
publisher = "Wiley-Blackwell",
number = "3",

}

Limited utility of ICD-10 and DSM-IV classification of dissociative and conversion disorders in India. / Alexander, P. J.; Joseph, S.; Das, A.

In: Acta Psychiatrica Scandinavica, Vol. 95, No. 3, 01.01.1997, p. 177-182.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Limited utility of ICD-10 and DSM-IV classification of dissociative and conversion disorders in India

AU - Alexander, P. J.

AU - Joseph, S.

AU - Das, A.

PY - 1997/1/1

Y1 - 1997/1/1

N2 - Studies of psychiatric out-patients from India have found that diagnosis of some of the subcategories of the dissociative and conversion disorders of the ICD and DSM classificatory systems are rarely made in this setting. Moreover, it was found that a significant percentage of patients seen in psychiatric practice may not fit into the defined subcategories of dissociative (conversion) disorders of these systems of classification. We studied the prevalence of various ICD-10 and DSM-IV categories of dissociative (conversion) disorders and our own proposed category of 'brief dissociative stupor' (BDS), among all the in-patients of a psychiatric unit in a general teaching hospital, over a 2-year period. There were 18 patients who fulfilled our criteria for BDS and 18 patients in the second group which included all of the remaining subjects with a diagnosis of any other subcategory of dissociative disorder according to ICD-10. Our analysis revealed that there were no patients with a diagnosis of dissociative amnesia, fugue, stupor, trance and possession disorders or identity disorders. There were significantly more female patients in the BDS group, and they also had significantly more comorbid Axis-I diagnoses and panic attacks. Since 50% of our patients fulfilled the criteria for BDS, there is clearly a need for further studies to establish the prevalence of this subcategory in patients from other centres. The classification of these patients with this phenomenology is problematic. Inclusion of a subcategory of dissociative non-epileptic seizures, instead of dissociative convulsions, should improve the classification of dissociative (conversion) disorders.

AB - Studies of psychiatric out-patients from India have found that diagnosis of some of the subcategories of the dissociative and conversion disorders of the ICD and DSM classificatory systems are rarely made in this setting. Moreover, it was found that a significant percentage of patients seen in psychiatric practice may not fit into the defined subcategories of dissociative (conversion) disorders of these systems of classification. We studied the prevalence of various ICD-10 and DSM-IV categories of dissociative (conversion) disorders and our own proposed category of 'brief dissociative stupor' (BDS), among all the in-patients of a psychiatric unit in a general teaching hospital, over a 2-year period. There were 18 patients who fulfilled our criteria for BDS and 18 patients in the second group which included all of the remaining subjects with a diagnosis of any other subcategory of dissociative disorder according to ICD-10. Our analysis revealed that there were no patients with a diagnosis of dissociative amnesia, fugue, stupor, trance and possession disorders or identity disorders. There were significantly more female patients in the BDS group, and they also had significantly more comorbid Axis-I diagnoses and panic attacks. Since 50% of our patients fulfilled the criteria for BDS, there is clearly a need for further studies to establish the prevalence of this subcategory in patients from other centres. The classification of these patients with this phenomenology is problematic. Inclusion of a subcategory of dissociative non-epileptic seizures, instead of dissociative convulsions, should improve the classification of dissociative (conversion) disorders.

UR - http://www.scopus.com/inward/record.url?scp=0030934084&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030934084&partnerID=8YFLogxK

U2 - 10.1111/j.1600-0447.1997.tb09617.x

DO - 10.1111/j.1600-0447.1997.tb09617.x

M3 - Article

VL - 95

SP - 177

EP - 182

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

SN - 0001-690X

IS - 3

ER -