The workshop focuses on differential diagnosis of dissociative symptoms and dissociative disorders (DD). The DD have a lifetime prevalence of about 10 % in international studies, and are prevalent as well in studies of inpatients, outpatients, partial hospital patients, substance-abuse patients, and emergency department patients. Dissociative symptoms are common comorbidities of many other psychiatric disorders. Most mental health professionals get training in dissociative disorders, particularly dissociative identity disorder (DID) and dissociative amnesia (DA), from the media. This workshop begins with a brief history of the dissociation concept, from the early 19th century to the present. Recent scholarship shows the classic “hysterics” studied and “showcased” by Charcot and his colleagues had profound histories of life-long sexual, physical, and/or emotional trauma, even wartime trauma during the Paris Commune of 1871. Dissociative symptoms and disorders have been described in combat soldiers as an outcome of every war since WW II. The Adverse Experiences (ACE) Study of over 17,000 employed US adults shows that increasing numbers of childhood adversities significantly predict later psychiatric disorders: depression, substance abuse (including smoking), auditory hallucinations, amnesia for life history, multiple psychiatric diagnoses; as well as self-destructive and suicidal behavior, and death by suicide. Increased numbers of ACEs predict early pregnancy, multiple sexual partners, and STD, among many other adverse social outcomes. Childhood sexual abuse predicts increased risk of pregnancy-related complications and children with autism spectrum disorder. It is a predictor of first episode mania. Multiple ACEs are associated with morbid obesity, heart disease, liver disease, lung disease, auto-immune disorders, migraine, chronic pain, and many other medical conditions, as well as a lower social trajectory and early death. Trauma itself must be inquired about in all diagnostic assessments, as it may be a major factor in the most common psychiatric disorders. In the differential diagnosis of DD, the issue is commonly one of co-morbidity, not differential diagnosis. DD patients typically spend many years in the mental health system before correct diagnosis. They are misdiagnosed as “treatment resistant” depression, rapid cycling bipolar disorder, “psychotic” – frequently schizo-affective disorder, conversion disorder, and borderline personality disorder (BPD). We describe a mental status examination for complex dissociation and dissociative disorder to help delineate the subtle differences between dissociative symptoms and symptoms of other disorders. The workshop will discuss differential diagnosis of DID and BPD, based in part on studies of the personality organization of DID.

After participating in this workshop, attendees should be able to:
    1. Differentiate individuals with dissociative identity disorder from those with borderline personality disorder, psychotic disorders, bipolar disorder, as well as assessing for co-morbidity of other disorders with dissociative identity disorder.

    2. Routinely evaluate all patients seeking mental health treatment for a history of psychological trauma, trauma-and-stressor-related disorders (i.e., PTSD), as well as dissociative symptoms/disorders and, in particular, reevaluate all patients with apparent “treatment resistant” disorders for a trauma history and dissociative symptoms/disorders.

    3. Consistently identify multiple childhood adversities as a predictor of the presence of major psychiatric disorders, substance use and addictive disorders, suicidality, non-suicidal self-injury, many medical disorders, adverse social outcomes, and early death.

 

We are excited to invite clinicians and researchers to this educational webinar.

March 17th 2022 (GMT+1, Brussels / Berlin / Warsaw / Madrid time), at 7.00-8.30 p.m.

REGISTRATION CLOSED

There is a fee of 20 euros for participation in the webinar. Payment should be made to the following bank account:

Name: European Society for Trauma and Dissociation
Account Number: NL02 INGB 0006 5231 37
adres:  Coldplaystraat 12 6663HX LENT The Netherlands
SWIFT code (or BIC): INGBNL2A
transfer title: webinar March 2022

 

Registration and payment is possible until March 14th (Monday), 2022. Registered persons who make the payment on March 14 should send a confirmation of the transfer to the e-mail address: assistant@estd.org

Participants are responsible to give correct informations in order to get access to the webinar. If the bank transfer is made from a company account, please provide your name and surname in the transfer description.

NB: Please be aware of inter-country money transaction time. ESTD will not be responsible of payments later than March 17th, 2022. However, payments received too late will be recompensed with the webinar recording sent by e-mail.

Cancellation is possible before the registration and payment deadline. By timely cancellation the fee will be reimbursed.

 

The recording of this webinar will be available later as video-on-demand at the same price. But clinical video clips used as illustration at the online webinar will not be available in the recording.

 

Active participants of the online webinar will receive a certificate of attendence. Certificates will not be issued to people who have merely watched the recording of this event.

The certificate will be taken into consideration when applying for an ESTD certificate in diagnosing trauma-related disorders and the referral system (currently under development).

 

Bio:

Richard Loewenstein, M.D., is Clinical Professor of Psychiatry at the University of Maryland School of Medicine, Baltimore, MD. He is the founder of, and from 1987-2020 was the Medical Director of The Trauma Disorders Program at Sheppard Pratt, Baltimore, MD, a national referral center for severely traumatized patients. He is rated by U.S. News and World Report as among America’s top 1 % of psychiatrists. Dr. Loewenstein did a research fellowship at the National Institute of Mental Health in Bethesda, MD, based in the Sleep Lab and the Consultation-Liaison Service. In the past he was a faculty member of the Departments of Psychiatry at Yale University, New Haven, CT; George Washington University, Washington, DC; and University of California, Los Angeles, CA. He is the author of approximately 100 papers and book chapters on dissociation, dissociative disorders, trauma disorders, dementia, delirium, somatic symptom disorders, and consultation-liaison psychiatry. He is the Section Editor, Dissociative Disorders, of the American Psychiatric Association (APA), DSM-5 Text Revision (DSM-5TR), to be published in Spring, 2022. He is co-editor of the 4th Revision (in preparation) of the International Society for the Study of Trauma and Dissociation (ISSTD) Guidelines for Treatment of Dissociative Identity Disorder in Adults. Since 2000, he has primarily been the lead author of the Dissociative Disorders chapter in Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. He is leading the revision of the Dissociative Disorders chapter for the upcoming (11th) edition of this textbook. He is a distinguished life fellow of the APA and, among other awards, has received the Lifetime Achievement Award of the ISSTD.

In his over 40 years as a psychiatric clinician and researcher, Dr. Loewenstein worked intensively with many patient populations before specializing in the dissociative disorders. At different times, he worked intensively with psychotic disorder patients; mood disorder patients in a national-referral mood disorders program; somatic symptom disorders; the interface of medical and psychiatric disorders; and neuropsychiatry, particularly delirium and dementia. From 1987-2020, he founded and led a national-referral Trauma Disorders Program, at Sheppard Pratt, Baltimore, MD, with referrals from across the USA and Canada, primarily to the inpatient Trauma Disorder Unit (TDU), first opened under his direction in 1992. Conservatively, partly because of the hundreds of inpatients admitted per year to the TDU from 1992 to 2020, Dr. Loewenstein has directly treated, supervised the treatment of, and/or consulted on the differential diagnosis and treatment of thousands of patients with DID and other dissociative disorders. In 1993, he published a classic paper: An Office Mental Status Examination for Complex Chronic Dissociative Symptoms and Multiple Personality Disorder (now dissociative identity disorder – DID) to assist clinicians in recognizing dissociative symptoms in the clinical interview and distinguishing these from similar symptoms in other disorders.