英語論文 大幅修正 ２

 Background

Dissociative disorder is a complex, protean, and intriguing condition whose understanding and treatment are still controversial among clinicians. The occurrence of dissociative symptoms is often unpredictable and sudden, which disturbs the social and daily function of individuals with this condition. Therefore, it requires our clinical attention; However, there is a general understanding among clinicians that there is no psychotropic medication that improves dissociative symptoms¹. Our clinical observations sometimes give us a glimpse of how some chemical agents might affect the degree and nature of dissociative conditions. Notably, some psychedelic or anesthetic agents are known to be “dissociative,” causing dissociation-like experiences among people without known dissociative disorder.
   Among  I initially noticed that some many abusive substances could markedly alter the dissociative symptoms in some patients. Especially, alcohol appears to affect the dissociative conditions in a potent way. One of my ce I had a chance to observe a patient who patient, showed a distinct change in his clinical symptom soon after he consumed alcohol. He was a middle-aged corporate employee with dissociative identity disorder (DID) was well who adapted to his daily office work. One day during his regular clinical visit, he was composed as usual and reported only occasional switching into different personalities. After the visit, on his way home he had a can of beer and got inebriated and decided to come back to have another “small chat” with me. When I saw him again, he demonstrated a rapid and uncontrollable shifts in personality. At one moment, he demonstrated a very challenging and emotional male personality state, making some derogatory remarks, then but he shifted back to his usual composed main personality and apologized to me for the rude behavior, (usually, this patient is often co-conscious of other personalities’ remarks and behaviors), only to go back to his challenging and wild state. In my observation, even consuming a small amount of alcohol or benzodiazepine can significantly reduce the threshold separating different personalities in DID patients.

On the contrary, stimulant drugs appeared to raise this threshold. One of my patients with DID, a woman in her twenties with a history of amphetamine abuse, stated her following experiences. She had occasional dissociative fugues that often disrupted her social and personal life. It is her observation that her fugue never occurs when she is under the influence of amphetamine. This was one of the reasons she kept using the drug to avoid having this fugue episode this occasional disruption in her social life.

＜以下略＞