Psychotherapy and Pharmacotherapy in Dissociative Disorders

This will be an open single arm "pilot" clinical trial on patients with dissociative disorders, admitted to the psychiatric emergency unit of Geneva and in the Hogan Psychotherapeutic Center in Montreux. Patients will be interviewed according to the Dissociative Experiences Scale (DES) and, if their score is 30 or higher, the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID) will be administered and, if the outcome on SCID is positive, the patient can be included in the study.

The patients will be treated by a psychiatrist who has experience with the use of the specific combined treatment for dissociative disorders (Damsa et al., 2005).

Inclusion Criteria:

1. Provision of written informed consent
2. DES-score greater than 30 and positive (DSM-IV) criteria for dissociative disorder using SCID for DSM IV
3. Age 18 - 65 years
4. Female patients of childbearing potential must have a negative urinary pregnancy test
5. Able to understand and comply with the requirements of the study
6. Good physical health as determined by medical history and physical examination.

Exclusion Criteria:

1. Pregnancy/lactation
2. Suicidal behaviour requiring hospitalisation or borderline personality disorder
3. Substance dependence
4. Treatment with psychotropic or cholesterol-lowering medication
5. Known intolerance or lack of response to the medication that will be prescribed in the study.
6. Unstable or inadequately treated medical illness (e.g. angina pectoris, hypertension, congestive heart failure) as judged by the investigator
7. Involvement in the planning and conduct of the study
8. Previous enrolment or randomisation of treatment in the present study.
9. Participation in another drug trial within 4 weeks prior enrolment into this study or longer in accordance with local requirements
10. The cytochrome P450 3A4 inhibitors and inducers

11. A patient with Diabetes Mellitus (DM) fulfilling one of the following criteria:

    • Unstable DM defined as enrollment glycosylated hemoglobin (HbA1c) >8.5%.
    • Admitted to hospital for treatment of DM or DM related illness in past 12 weeks.
    • Not under physician care for DM
    • Physician responsible for patient's DM care has not indicated that patient's DM is controlled.
    • Physician responsible for patient's DM care has not approved patient's participation in the study
    • Has not been on the same dose of oral hypoglycaemic drug(s) and/or diet for the 4 weeks prior to randomization. For thiazolidinediones (glitazones) this period should not be less than 8 Weeks.
    • Taking insulin whose daily dose on one occasion in the past 4 weeks has been more than 10% above or below their mean dose in the preceding 4 weeks *Note: If a diabetic patient meets one of these criteria, the patient is to be excluded even if the treating physician believes that the patient is stable and can participate in the study.
12. An absolute neutrophil count (ANC) of greater than 1.5 x 109/L