Treatment

The principles of assessment of people with unexplained symptoms involve consideration of psychological factors from the outset, appropriate physical investigations to exclude a physical cause, understanding the person’s beliefs and expectations, identification of anxiety/depression or other psychiatric disorders and detection of underlying psychosocial problems.

The principles of treatment of people with medically unexplained symptoms include acknowledging that the symptoms are real and that medical care is appropriate, providing physical treatment for associated or identified physical disease, explanation and reassurance, discussion of psychological factors, treatment of any associated psychiatric disorder, agreeing a treatment plan and avoidance of unnecessary further investigation.

Treatment varies according to the type and severity of the dissociative disorder but is likely to include a combination of methods that include:

Psychotherapy (a form of counselling) is the main form of treatment.

Cognitive behaviour therapy which helps to change dysfunctional thinking patterns.

Family therapy which helps to educate the family about the disorder and help them to recognise symptoms of a recurrence.

Creative therapies (art therapy, music therapy etc) which help the person explore and express their feelings in a secure and creative fashion.

The use of hypnotherapy is controversial. It can help to recover any repressed memories linked to the disorder but runs the risk of creating false memories by unintended suggestion by the therapist.

Medication

Although there is no specific medication to treat dissociative disorder, medication may help associated conditions such as anxiety or depression. Certain medicines (anticonvulsants and SSRIs) may have specific effects on depersonalisation and derealisation.

Amended May 2009