Co-occurrence of dissociation and anxiety and depressive disorders in adults: a scoping review
Abstract
Background: Dissociation, including depersonalization, derealization, dissociative identity disorder or dissociation in the context of functional neurological disorder, is classically associated with trauma-related disorders but is increasingly reported in anxiety and depressive disorders. Despite growing evidence linking dissociation to affective symptom severity, functional impairment, and treatment outcomes, its role in anxiety and depression remains insufficiently synthesized.
Objective: This scoping review aimed to map the extent, nature, and characteristics of dissociation in adults with anxiety and depressive symptoms, with a focus on conceptualization, assessment methods, prevalence, and clinical correlates.
Methods: Using Joanna Briggs Institute methodology and PRISMA-ScR guidelines, PubMed and Scopus were searched from inception to January 2025. Studies assessing dissociation in adults with anxiety and/or depressive symptoms using validated instruments or clinical interviews were included. Data were charted and synthesized thematically.
Results: A total of 300 studies were included. Of these, 49 studies focused on depersonalization-derealization phenomena, 11 studies examined dissociative identity disorder or complex dissociative disorders, 139 studies investigated functional neurological disorders, and 101 studies addressed mixed or transdiagnostic dissociative phenomena. Across anxiety and depressive disorders, dissociative symptoms were common and dimensionally…
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