Dissociation and psychotic symptoms in a non-psychotic inpatient sample, a latent profile analysis

Abstract

Purpose

Considering the clinical relevance of the association between dissociation and psychotic symptoms for the differential diagnosis of psychotic symptoms, we investigated the distribution and type of dissociative and psychotic symptoms in inpatients with non-psychotic disorders.

Basic procedures

We used routine data from 1020 patients to conduct latent profile analyses using the German version of the Dissociative Experiences Scale and items from the Symptom Checklist-90-Revised, which captures psychotic symptoms.

Main findings

Exploratory factor analysis revealed two qualitatively distinct factors of psychotic symptoms, one comprising paranoid ideation and the other perceptual and self-disturbances. Subsequent latent profile analysis revealed a three profile solution of dissociative and psychotic symptoms. One profile was characterized by almost no paranoid ideation and no perceptual and self-disturbances, one profile was characterized by almost exclusively paranoid ideation and the last profile was characterized by up to the most severe perceptual and self-disturbances combined with paranoid ideation. The first profile showed no pathological dissociation, in the second profile mainly absorption and derealization/depersonalization in particular were elevated, while the last profile was associated with severe dissociation on all subscales.

Principal conclusions

The results indicate a close relationship between dissociation and psychotic symptoms in non-psychotic disorders. While paranoid ideation appears to be associated with moderate dissociation, perceptual and self-disturbances are almost exclusively present in the profile with the strongest dissociation. Therefore, dissociation should be considered in the differential diagnosis of psychotic symptoms, and psychotic symptoms in non-psychotic disorders may benefit from approaches that address dissociation.