Antje A T S Reinders1, Andre F Marquand2, Yolanda R Schlumpf3, Sima Chalavi4, Eline M Vissia5, Ellert R S Nijenhuis6, Paola Dazzan7, Lutz Jäncke8, Dick J Veltman9. 1. Senior Research Associate with Lecturer status, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and Department of Neuroscience, University Medical Center Groningen, University of Groningen, The Netherlands. 2. Assistant Professor, Donders Institute for Brain Cognition and Behaviour, Radboud University, The Netherlands and Honorary Lecturer, Department of Clinical Neuroscience, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK. 3. Postdoctoral Assistant, Division of Neuropsychology, Department of Psychology, University of Zurich and Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Switzerland. 4. Postdoctoral Researcher, Department of Neuroscience, University Medical Center Groningen, University of Groningen, The Netherlands and Research Center for Movement Control and Neuroplasticity, Department of Movement Sciences, Katholieke Universiteit Leuven, Belgium. 5. Mental Healthcare Psychologist, Department of Neuroscience, University Medical Center Groningen, University of Groningen and Top Referent Trauma Centrum, GGz Centraal, The Netherlands. 6. Psychologist/Psychotherapist, Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Switzerland. 7. Professor of Neurobiology of Psychosis, Vice Dean International, Honorary Consultant Psychiatrist, Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK. 8. Professor of Neuropsychology, Scientific Director, Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy and Research Unit for Plasticity and Learning of the Healthy Aging Brain, University of Zurich, Switzerland. 9. Professor of Neuroimaging in Psychiatry, Department of Psychiatry, VU University Medical Center, The Netherlands.
Abstract
BACKGROUND: A diagnosis of dissociative identity disorder (DID) is controversial and prone to under- and misdiagnosis. From the moment of seeking treatment for symptoms to the time of an accurate diagnosis of DID individuals received an average of four prior other diagnoses and spent 7 years, with reports of up to 12 years, in mental health services. AIM: To investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis. METHOD: Structural brain images of 75 participants were included: 32 female individuals with DID and 43 matched healthy controls. Individuals with DID were recruited from psychiatry and psychotherapy out-patient clinics. Probabilistic pattern classifiers were trained to discriminate cohorts based on measures of brain morphology. RESULTS: The pattern classifiers were able to accurately discriminate between individuals with DID and healthy controls with high sensitivity (72%) and specificity (74%) on the basis of brain structure. These findings provide evidence for a biological basis for distinguishing between DID-affected and healthy individuals. CONCLUSIONS: We propose a pattern of neuroimaging biomarkers that could be used to inform the identification of individuals with DID from healthy controls at the individual level. This is important and clinically relevant because the DID diagnosis is controversial and individuals with DID are often misdiagnosed. Ultimately, the application of pattern recognition methodologies could prevent unnecessary suffering of individuals with DID because of an earlier accurate diagnosis, which will facilitate faster and targeted interventions. DECLARATION OF INTEREST: The authors declare no competing financial interests.
BACKGROUND: A diagnosis of dissociative identity disorder (DID) is controversial and prone to under- and misdiagnosis. From the moment of seeking treatment for symptoms to the time of an accurate diagnosis of DID individuals received an average of four prior other diagnoses and spent 7 years, with reports of up to 12 years, in mental health services. AIM: To investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis. METHOD: Structural brain images of 75 participants were included: 32 female individuals with DID and 43 matched healthy controls. Individuals with DID were recruited from psychiatry and psychotherapy out-patient clinics. Probabilistic pattern classifiers were trained to discriminate cohorts based on measures of brain morphology. RESULTS: The pattern classifiers were able to accurately discriminate between individuals with DID and healthy controls with high sensitivity (72%) and specificity (74%) on the basis of brain structure. These findings provide evidence for a biological basis for distinguishing between DID-affected and healthy individuals. CONCLUSIONS: We propose a pattern of neuroimaging biomarkers that could be used to inform the identification of individuals with DID from healthy controls at the individual level. This is important and clinically relevant because the DID diagnosis is controversial and individuals with DID are often misdiagnosed. Ultimately, the application of pattern recognition methodologies could prevent unnecessary suffering of individuals with DID because of an earlier accurate diagnosis, which will facilitate faster and targeted interventions. DECLARATION OF INTEREST: The authors declare no competing financial interests.
Authors: Lauren A M Lebois; Meiling Li; Justin T Baker; Jonathan D Wolff; Danhong Wang; Ashley M Lambros; Elizabeth Grinspoon; Sherry Winternitz; Jianxun Ren; Atilla Gönenç; Staci A Gruber; Kerry J Ressler; Hesheng Liu; Milissa L Kaufman Journal: Am J Psychiatry Date: 2020-09-25 Impact factor: 18.112
Authors: Antje A T S Reinders; Lora I Dimitrova; Yolanda R Schlumpf; Eline M Vissia; Ellert R S Nijenhuis; Lutz Jäncke; Sima Chalavi; Dick J Veltman Journal: BJPsych Open Date: 2022-03-15
Authors: Eline M Vissia; Andrew J Lawrence; Sima Chalavi; Mechteld E Giesen; Nel Draijer; Ellert R S Nijenhuis; André Aleman; Dick J Veltman; Antje A T S Reinders Journal: BJPsych Open Date: 2022-04-11
Authors: Lora Dimitrova; Vinuri Fernando; Eline M Vissia; Ellert R S Nijenhuis; Nel Draijer; Antje A T S Reinders Journal: Eur J Psychotraumatol Date: 2020-01-13