Dissociative and neuropsychological symptoms: The question of differential diagnosis

Recent literature raises questions about the relationship between dissociative symptoms and neurological disorders. In this article, we consider issues pertinent to the differential diagnosis of dissociative disorders. We discuss DSM-IV dissociative disorders and their assessment, as well as symptom overlap between dissociative disorders and a number of neurological conditions (primarily temporal lobe epilepsy, TLE), which resemble dissociative symptoms. We argue that dissociative symptoms may be conceptualized as anxiety based, defensive responses to prior physical and/or psychological trauma. In tabular format, we propose a tentative scheme to assist clinicians in making diagnostic decisions.