4. 6 ORGANIC DISSOCIATIVE DISORDER
ICD-10 (World Health Organization, 1992) presents organic
dissociative disorder as a disorder that meets the criteria for one of the
dissociative (conversion) disorders and for which the general criteria for
organic etiology are also fulfilled. Dissociative disorders can be induced
by substances like alcohol, barbiturates and similarly acting hypnotics,
benzodiazepines, beta-adrenergic blockers, cannabis and certain
psychedelic drugs, and general anesthetics (Good, 1989). Dissociative
phenomena are common in patients with epilepsy, especially in those with a
temporal lobe focus (Schenk and Bear, 1981). Ganser syndrome has been
reported in association with toxic confusional states, head injury,
general paresis, and postpartum psychoses (Whitlock, 1967). Tyrone and
Fernandez (2000) report a patient with a colloid cyst of the third
ventricle that presented with dissociative fugues.
Few follow-up studies underline the
importance of detecting neurological illnesses in patients diagnosed as
having dissociative disorders. Slater (1965) found that 60% of patients
diagnosed with conversion hysteria developed diagnosable neurological
illness in the ensuing decade. Mace and Trimble (1996) found that 15% of
patients with a diagnosis of hysteria and investigated for neurological
symptoms had an established neurological diagnosis 10 years later. |
