Aiding the diagnosis of dissociative identity disorder: pattern recognition study of brain biomarkers
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...
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Veröffentlicht in: | British journal of psychiatry 2019-09, Vol.215 (3), p.536-544 |
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creator | Reinders, Antje A. T. S. Marquand, Andre F. Schlumpf, Yolanda R. Chalavi, Sima Vissia, Eline M. Nijenhuis, Ellert R. S. Dazzan, Paola Jäncke, Lutz Veltman, Dick J. |
description | 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.
To investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis.
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.
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.
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.
The authors declare no competing financial interests. |
doi_str_mv | 10.1192/bjp.2018.255 |
format | Article |
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To investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis.
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.
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.
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.
The authors declare no competing financial interests.</description><identifier>ISSN: 0007-1250</identifier><identifier>EISSN: 1472-1465</identifier><identifier>DOI: 10.1192/bjp.2018.255</identifier><identifier>PMID: 30523772</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Acknowledgment ; Adult ; Adverse Childhood Experiences ; Biological markers ; Biomarkers ; Brain ; Brain Mapping - methods ; Brain structure ; Case-Control Studies ; Classification ; Comorbidity ; Diagnosis ; Diagnosis, Differential ; Dissociative disorders ; Dissociative identity disorder ; Dissociative Identity Disorder - diagnosis ; Dissociative Identity Disorder - pathology ; Female ; Gray Matter - pathology ; Health services utilization ; Help seeking behavior ; Humans ; Identity ; Magnetic Resonance Imaging ; Male ; Medical diagnosis ; Medical imaging ; Mental disorders ; Mental health services ; Misdiagnosis ; Morphology ; Neuroimaging ; NMR ; Nuclear magnetic resonance ; Pattern recognition ; Personality disorders ; Post traumatic stress disorder ; Prone ; Psychiatry ; Psychotherapy ; Sensitivity and Specificity ; Stress Disorders, Post-Traumatic - diagnosis ; Stress Disorders, Post-Traumatic - pathology ; Suffering ; White Matter - pathology</subject><ispartof>British journal of psychiatry, 2019-09, Vol.215 (3), p.536-544</ispartof><rights>Copyright © The Royal College of Psychiatrists 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c429t-571db33a6856aec351e581d66378ede18cb8f42963be463ac89e9d36fd03406c3</citedby><cites>FETCH-LOGICAL-c429t-571db33a6856aec351e581d66378ede18cb8f42963be463ac89e9d36fd03406c3</cites><orcidid>0000-0002-7987-1532</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S0007125018002556/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,315,781,785,12851,27349,27929,27930,31004,33779,55633</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30523772$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reinders, Antje A. T. S.</creatorcontrib><creatorcontrib>Marquand, Andre F.</creatorcontrib><creatorcontrib>Schlumpf, Yolanda R.</creatorcontrib><creatorcontrib>Chalavi, Sima</creatorcontrib><creatorcontrib>Vissia, Eline M.</creatorcontrib><creatorcontrib>Nijenhuis, Ellert R. S.</creatorcontrib><creatorcontrib>Dazzan, Paola</creatorcontrib><creatorcontrib>Jäncke, Lutz</creatorcontrib><creatorcontrib>Veltman, Dick J.</creatorcontrib><title>Aiding the diagnosis of dissociative identity disorder: pattern recognition study of brain biomarkers</title><title>British journal of psychiatry</title><addtitle>Br J Psychiatry</addtitle><description>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.
To investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis.
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.
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.
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.
The authors declare no competing financial interests.</description><subject>Acknowledgment</subject><subject>Adult</subject><subject>Adverse Childhood Experiences</subject><subject>Biological markers</subject><subject>Biomarkers</subject><subject>Brain</subject><subject>Brain Mapping - methods</subject><subject>Brain structure</subject><subject>Case-Control Studies</subject><subject>Classification</subject><subject>Comorbidity</subject><subject>Diagnosis</subject><subject>Diagnosis, Differential</subject><subject>Dissociative disorders</subject><subject>Dissociative identity disorder</subject><subject>Dissociative Identity Disorder - diagnosis</subject><subject>Dissociative Identity Disorder - pathology</subject><subject>Female</subject><subject>Gray Matter - pathology</subject><subject>Health services utilization</subject><subject>Help seeking behavior</subject><subject>Humans</subject><subject>Identity</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical imaging</subject><subject>Mental disorders</subject><subject>Mental health services</subject><subject>Misdiagnosis</subject><subject>Morphology</subject><subject>Neuroimaging</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Pattern recognition</subject><subject>Personality disorders</subject><subject>Post traumatic stress disorder</subject><subject>Prone</subject><subject>Psychiatry</subject><subject>Psychotherapy</subject><subject>Sensitivity and Specificity</subject><subject>Stress Disorders, Post-Traumatic - diagnosis</subject><subject>Stress Disorders, Post-Traumatic - pathology</subject><subject>Suffering</subject><subject>White Matter - pathology</subject><issn>0007-1250</issn><issn>1472-1465</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>BHHNA</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkE1LAzEQhoMoWqs3z7LgxYNb87HJ7noT8QsKXvQcsslsTW2TmmSF_ntTrAriKUx45p2ZB6ETgieEtPSym68mFJNmQjnfQSNS1bQkleC7aIQxrktCOT5AhzHOc8kqWu-jA4Y5ZXVNRwiurbFuVqRXKIxVM-ejjYXvcxGj11Yl-wGFNeCSTevNrw8GwlWxUilBcEUA7WfOJutdEdNg1pvmLijris76pQpvEOIR2uvVIsLx9h2jl7vb55uHcvp0_3hzPS11RdtU8pqYjjElGi4UaMYJ8IYYIVjdgAHS6K7pMylYB5VgSjcttIaJ3uTDsNBsjM6_clfBvw8Qk1zaqGGxUA78ECUlnLdV1eI2o2d_0LkfgsvbSUobRgkWbZWpiy9KBx9jgF6ugs1HrSXBcqNfZv1yo19m_Rk_3YYO3RLMD_ztOwOTbZ5adsGaGfyO_TfxE0dokBI</recordid><startdate>20190901</startdate><enddate>20190901</enddate><creator>Reinders, Antje A. 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T. S. ; Marquand, Andre F. ; Schlumpf, Yolanda R. ; Chalavi, Sima ; Vissia, Eline M. ; Nijenhuis, Ellert R. 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T. S.</au><au>Marquand, Andre F.</au><au>Schlumpf, Yolanda R.</au><au>Chalavi, Sima</au><au>Vissia, Eline M.</au><au>Nijenhuis, Ellert R. S.</au><au>Dazzan, Paola</au><au>Jäncke, Lutz</au><au>Veltman, Dick J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Aiding the diagnosis of dissociative identity disorder: pattern recognition study of brain biomarkers</atitle><jtitle>British journal of psychiatry</jtitle><addtitle>Br J Psychiatry</addtitle><date>2019-09-01</date><risdate>2019</risdate><volume>215</volume><issue>3</issue><spage>536</spage><epage>544</epage><pages>536-544</pages><issn>0007-1250</issn><eissn>1472-1465</eissn><abstract>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.
To investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis.
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.
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.
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.
The authors declare no competing financial interests.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>30523772</pmid><doi>10.1192/bjp.2018.255</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7987-1532</orcidid><oa>free_for_read</oa></addata></record> |
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source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Cambridge University Press Journals; Alma/SFX Local Collection; Sociological Abstracts; EZB Electronic Journals Library |
subjects | Acknowledgment Adult Adverse Childhood Experiences Biological markers Biomarkers Brain Brain Mapping - methods Brain structure Case-Control Studies Classification Comorbidity Diagnosis Diagnosis, Differential Dissociative disorders Dissociative identity disorder Dissociative Identity Disorder - diagnosis Dissociative Identity Disorder - pathology Female Gray Matter - pathology Health services utilization Help seeking behavior Humans Identity Magnetic Resonance Imaging Male Medical diagnosis Medical imaging Mental disorders Mental health services Misdiagnosis Morphology Neuroimaging NMR Nuclear magnetic resonance Pattern recognition Personality disorders Post traumatic stress disorder Prone Psychiatry Psychotherapy Sensitivity and Specificity Stress Disorders, Post-Traumatic - diagnosis Stress Disorders, Post-Traumatic - pathology Suffering White Matter - pathology |
title | Aiding the diagnosis of dissociative identity disorder: pattern recognition study of brain biomarkers |
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