Dissociative depression and its related clinical and psychological characteristics among Chinese prisoners: A latent class analysis

Although dissociative symptoms are common in depression patients and dissociative depression might be one subtype of depression, no study has tested this subtype using latent class analysis (LCA). This study aimed to identify the subgroup of dissociative depression and further examined its related validators in a cohort of high-risk population. Depressive symptoms and dissociative experiences were measured by the Patient Health Questionnaire-9 and the Brief Dissociative Experiences Scale among 1708 male prisoners. Participants' symptoms of post-traumatic stress disorder (PTSD), antisocial personality disorder (APD), borderline personality disorder (BPD), insomnia, social support, childhood trauma, histories of substance abuse and gambling addiction, as well as their ability of emotion processing were also assessed. Four latent groups were identified by LCA, including dissociative depression (3.9%), classic depression (13.9%), classic dissociation (7.9%), and low symptoms group (74.3%). Dissociative depression reported the highest severity of PTSD, depression, dissociation, BPD, APD and insomnia; classic depression had much more depression than classic dissociation; while classic dissociation had more severity of dissociation, PTSD, APD, and BPD than classic depression. Furthermore, physical neglect and perceived social supports could distinguish the four groups. Finally, dissociative depression reported more difficulties in emotion regulation and showed more negative emotion expressivity and impulse than other groups. The findings imply existence of dissociative depression subtype, but replications are needed in various samples. Dissociative depression manifests more severe psychopathology than the remaining patients, indicating enhanced clinical needs for this subgroup. Further studies are needed to better understand mechanisms and treatment options for dissociative depression.