Am J Psychiatry 1991; 148:1050-1054
Copyright © 1991 by American Psychiatric Association
Detection of dissociative disorders in psychiatric patients by a screening instrument and a structured diagnostic interview
M Steinberg, B Rounsaville and D Cicchetti
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06508.
OBJECTIVE AND METHOD: Diagnosis and treatment of the dissociative disorders
may be delayed for many years because of difficulties in detecting patients
at high risk for dissociative disorders. This study investigates the
utility of the Dissociative Experiences Scale (DES), a self-report
instrument for dissociative experiences, in detecting patients at high risk
for dissociative disorders. The clinician- administered Structured Clinical
Interview for DSM-III-R Dissociative Disorders (SCID-D) was used as the
diagnostic standard, and 36 outpatients with mixed diagnoses and nine
normal subjects were evaluated for the presence and absence of a
dissociative disorder. DES scores were then compared. RESULTS: Results
indicate that a DES cutoff score of 15-20 yields good to excellent
sensitivity and specificity as a screening instrument. However, for higher
cutoff points the sensitivity can be much lower. CONCLUSIONS: Thus,
although the DES can be used to identify some high-risk patients, they
should be further evaluated with such diagnostic instruments as the SCID-D
or by in-depth clinical follow-up.
