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Prevalence of the dissociative subtype of post-traumatic stress disorder: a systematic review and meta-analysis

Published online by Cambridge University Press:  23 June 2022

William F. White Open the ORCID record for William F. White [Opens in a new window] ,
Aaron Burgess Open the ORCID record for Aaron Burgess [Opens in a new window] ,
Tim Dalgleish Open the ORCID record for Tim Dalgleish [Opens in a new window] ,
Sarah Halligan Open the ORCID record for Sarah Halligan [Opens in a new window] ,
Rachel Hiller Open the ORCID record for Rachel Hiller [Opens in a new window] ,
Anna Oxley ,
Patrick Smith Open the ORCID record for Patrick Smith [Opens in a new window]  and
Richard Meiser-Stedman Open the ORCID record for Richard Meiser-Stedman [Opens in a new window]
William F. White
Affiliation:
Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
Aaron Burgess
Affiliation:
Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
Tim Dalgleish
Affiliation:
Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
Sarah Halligan
Affiliation:
Department of Psychology, University of Bath, Bath, UK
Rachel Hiller
Affiliation:
Division of Psychology and Language Sciences, University College London, London, UK Anna Freud Centre for Children and Families, London, UK
Anna Oxley
Affiliation:
Cambridgeshire Community Services NHS Trust, UK
Patrick Smith
Affiliation:
Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK South London & Maudsley NHS Foundation Trust, UK
Richard Meiser-Stedman*
Affiliation:
Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
*
Author for correspondence: Richard Meiser-Stedman, E-mail: r.meiser-stedman@uea.ac.uk
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Abstract

The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and is characterised by symptoms of either depersonalisation or derealisation, in addition to a diagnosis of post-traumatic stress disorder (PTSD). This systematic review and meta-analysis sought to estimate the point prevalence of current PTSD-DS, and the extent to which method of assessment, demographic and trauma variables moderate this estimate, across different methods of prevalence estimation. Studies included were identified by searching MEDLINE (EBSCO), PsycInfo, CINAHL, Academic Search Complete and PTSDpubs, yielding 49 studies that met the inclusion criteria (N = 8214 participants). A random-effects meta-analysis estimated the prevalence of PTSD-DS as 38.1% (95% CI 31.5–45.0%) across all samples, 45.5% (95% CI 37.7–53.4%) across all diagnosis-based and clinical cut-off samples, 22.8% (95% CI 14.8–32.0%) across all latent class analysis (LCA) and latent profile analysis (LPA) samples and 48.1% (95% CI 35.0–61.3%) across samples which strictly used the DSM-5 PTSD criteria; all as a proportion of those already with a diagnosis of PTSD. All results were characterised by high levels of heterogeneity, limiting generalisability. Moderator analyses mostly failed to identify sources of heterogeneity. PTSD-DS was more prevalent in children compared to adults, and in diagnosis-based and clinical cut-off samples compared to LCA and LPA samples. Risk of bias was not significantly related to prevalence estimates. The implications of these results are discussed further.

Keywords

Meta-analysispost-traumatic stress disorderprevalencesystematic review

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Type
Review Article
Information
Psychological Medicine , Volume 52 , Issue 9 , July 2022 , pp. 1629 - 1644
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Copyright © The Author(s), 2022. Published by Cambridge University Press

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