questions abt dissociative psychosis

● Psychotic Presentations of Dissociative Identity Disorder (Vedat Sar & Erdinç Öztürk)
● Dissociative psychosis: Clinical and theoretical aspects (Onno van der Hart & Eliezer Witztum)
● Dissociation and Psychosis in Dissociative Identity Disorder and Schizophrenia (Andreas Laddis & Paul F. Dell)

From the perspectives of the recent academic studies (such as above)...

1. Would people suffering from dissociative psychosis(DP) have impairment in reality testing (loss from reality)?

2. Generally, "psychosis" refer to "loss of contact with reality", and does dissociative psychosis(DP) include the feature of "loss of contact with reality"?

3. " Their(DID's) reality testing is intact except during DP episodes. " Is it meaning that people under DP would not have intact reality testing?

4. Normal psychosis usually requires antipsychotics, how about DP? Any more academic guidelines?

Thanks!

Woodreus18, so that I know where you are starting from in asking these questions, have you read these papers, or only the abstracts?

Can you describe what you understand to be the subjective experience of "loss of contact with reality"? Some persons who read this phrase imagine it refers to the fogginess and other symptoms of depersonalization. What do you think it refers to?

In their book chapter Psychotic Presentations of Dissociative Identity Disorder, Sar and Öztürk explain dissociative psychosis in part as follows:

The American Psychiatric Glossary (Stone, 1988) defines reality testing as the ability to evaluate the external world objectively and to differentiate adequately between it and the internal world. Impaired reality testing is one of the major hallmarks of psychosis. Patients with DID or related types of DDNOS usually have insight into their illness. Their reality testing is intact except during DP episodes.

The dissociative patient’s reported claim of containing another person’s existence, or of having more than one personality, cannot be considered a delusion. Such claims do not originate from a primary thought disorder, but rather from experience itself—the actual experience of the other as “not me” (Sullivan, 1953). In contrast, the delusions of a schizophrenic patient are thought to be the result of a primary disturbance of thought content.

Would people suffering from dissociative psychosis (DP) have impairment in reality testing aka "loss of contact with reality? Yes, briefly. If reality testing is not impaired there is no psychosis.

Psychosis often is treated with medications. These may be helpful in a patient with DID who also has significant psychosis, but are not always helpful even in this group. Episodes of DP generally are brief and often resolve without any medication.

The ISSTD guidelines on treating DID in adults discuss medications.