Review Article

Dissociative Disorder in the Iranian Culture: The Lawless Utopia


Epidemiologic and etiological studies of dissociative disorders are a challenging area in psychiatry. These challenges become more complex when noting that the existing theories cannot explain the differences observed in certain cases; for example, studies in Iran have reported the prevalence of dissociative disorders (dissociative amnesia, dissociative fugue, and depersonalization disorder) as less than 0.6%, and there has been no reported case of dissociative identity disorder (DID) in this country; meanwhile, the prevalence of all dissociative disorders in the general population of the US has been reported as 18.3%, and the prevalence of DID as about 1.1%. Although several studies indicate the high prevalence of dissociative symptoms in many Iranian psychiatric illnesses, dissociative disorders as a stand-alone disorder have a very low prevalence in Iran. The present article attempts to propose a possible hypothesis for the answer to the above questions through a different cultural conceptualization and seeks to be of some help to future studies in this area. Certainly, this hypothesis requires a careful study to be validated.

1. American Psychiatric Association A, Association AP. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Association; 2013.
2. Reategui AA. Dissociative Identity Disorder: A Literature Review. Undergraduate Journal of Psychology. 2019:22-7.
3. Kate MA, Hopwood T, Jamieson G. The prevalence of Dissociative Disorders and dissociative experiences in college populations: a meta-analysis of 98 studies. J Trauma Dissociation. 2020;21(1):16-61.
4. Tseng W-S. Handbook of cultural psychiatry: Academic Press; 2001.
5. Goffinet SJL, Beine A. Prevalence of dissociative symptoms in adolescent psychiatric inpatients. J Trauma Dissociation. 2018;2(1):39-45.
6. Jarvis GE, Kirmayer LJ, Gómez-Carrillo A, Aggarwal NK, Lewis-Fernández R. Update on the Cultural Formulation Interview. Focus (Am Psychiatr Publ). 2020;18(1):40-6.
7. Mohammadi MR, Davidian H, Noorbala AA, Malekafzali H, Naghavi HR, Pouretemad HR, et al. An epidemiological survey of psychiatric disorders in Iran. Clin Pract Epidemiol Ment Health. 2005;1:16.
8. Noorbala AA, Faghihzadeh S, Kamali K, Bagheri Yazdi SA, Hajebi A, Mousavi MT, et al. Mental Health Survey of the Iranian Adult Population in 2015. Arch Iran Med. 2017;20(3):128-34.
9. Kaplan BJ. Kaplan and sadock’s synopsis of psychiatry. Behavioral sciences/clinical psychiatry. Tijdschrift voor Psychiatrie. 2016;58(1): 78-9.
10. Dorahy MJ, Brand BL, Sar V, Krüger C, Stavropoulos P, Martínez-Taboas A, et al. Dissociative identity disorder: An empirical overview. Aust N Z J Psychiatry. 2014;48(5):402-17.
11. Kianpoor M, Rhoades GF. Djinnati, A Possession State in Baloochistan, Iran. Journal of Trauma Practice. 2006;4(1-2):147-55.
12. Bakhshani NM, Hosseinbore N, Kianpoor M. Djinnati syndrome: symptoms and prevalence in rural population of Baluchistan (southeast of Iran). Asian J Psychiatr. 2013;6(6):566-70.
13. Firoozabadi A, Golshani S, Razeghian L, Rahimi S, Sepehry AA, Farnia V, et al. Dissociative Experiences In Iranian Depressed Patients. J Trauma Dissociation. 2019;20(4):445-56.
14. Golshani S, Ghanbari S, Firoozabadi A, Shakeri J, Hookari S, Rahami B, et al. Dissociative Symptoms and Self-Reported Childhood and Current Trauma in Male Incarcerated People with Borderline Personality Disorder - Results from a Small Cross-Sectional Study in Iran. Neuropsychiatr Dis Treat. 2020;16:2407-17.
15. Nejad AG, Farahati H. Dissociative disorders and dissociative symptoms among veterans of the Iraq-Iran war suffering from chronic post-traumatic disorder. Neurosciences (Riyadh). 2007;12(4):318-21.
16. Ganguli HC. Epidemiological findings on prevalence of mental disorders in India. Indian J Psychiatry. 2000;42(1):14-20.
17. Chaturvedi SK, Desai G, Shaligram D. Dissociative disorders in a psychiatric institute in India--a selected review and patterns over a decade. Int J Soc Psychiatry. 2010;56(5):533-9.
18. Guarnaccia PJ, Canino G, Rubio-Stipec M, Bravo M. The prevalence of ataques de nervios in the Puerto Rico disaster study. The role of culture in psychiatric epidemiology. J Nerv Ment Dis. 1993;181(3):157-65.
19. Sharifi V, Amin-Esmaeili M, Hajebi A, Motevalian A, Radgoodarzi R, Hefazi M, et al. Twelve-month prevalence and correlates of psychiatric disorders in Iran: the Iranian Mental Health Survey, 2011. Arch Iran Med. 2015;18(2):76-84.
20. Ainehvand S, Raeissi P, Ravaghi H, Maleki M. Natural disasters and challenges toward achieving food security response in Iran. J Educ Health Promot. 2019;8:51.
21. Ghomian Z, Yousefian S. Natural disasters in the Middle-East and North Africa With a focus on Iran: 1900 to 2015. Health in Emergencies and Disasters. 2017;2(2):53-62.
22. Mozafari A, Nozhat B, Ehsani M. The Influence of Socio-Political Transformations on the Formation of the Image of “Utopia” in Mystical Poems. Persian Language and Literature. 2019;27(1): 215-233.
23. Moeini SHI. The Islamic Utopia and the Contemporary Statesmanship: The Strange Case of Tehran's New Cultural District. International Journal of the Constructed Environment. 2020;11(1).
24. Asil H. Utopias in Iranian Thought: Ney publication [IN PERSIAN]; 2002.
25. Ahmadnezhad A, Motlaq M. A Sociological Study of Authoritarianism in the Pahlavi Era. IAU International Journal of Social Sciences. 2018;8(4):69-82.
26. Milani A. The Quest for Democracy in Iran: A Century of Struggle Against Authoritarian Rule. Political Science Quarterly.2009;124(3):589-91.
27. Dwairy MA. Counseling and psychotherapy with Arabs and Muslims: A culturally sensitive approach: Teachers College Press; 2006.
28. Cordesman AH. The Crisis in Iran: What Now? 2018.[Available from:
29. Hatef B, Mohammadi A, Yaribeygi H, Meftahi G. Intensity and prevalence of source of stress in Iran. Health research journal. 2016;1(1):43-57.
30. Noorbala AA, Rafiey H, Alipour F, Moghanibashi-Mansourieh A. Psychosocial Stresses and Concerns of People Living in Tehran: A Survey on 6000 Adult Participants. Iran J Psychiatry. 2018;13(2):94-102.
31. Javidan M, Dastmalchian A. Culture and leadership in Iran: The land of individual achievers, strong family ties, and powerful elite. Academy of Management Perspectives. 2003;17(4):127-142.
32. Javidan M, Dastmalchian A. Managerial implications of the GLOBE project: A study of 62 societies. Asia Pacific Journal of Human Resources. 2009;47(1):41-58.
33. Shahlaei A, Mohajeri M. In-Between Space, Dialectic of Inside and Outside in Architecture. International Journal of Architecture and Urban Development. 2015;5(3):73-80.
34. Levitas R. The concept of utopia: Peter Lang; 2010.
35. Badaan V, Jost JT, Fernando J, Kashima Y. Imagining better societies: A social psychological framework for the study of utopian thinking and collective action. Social and Personality Psychology Compass. 2020;14(4):1-14.
36. Katouzian H. Iranian history and politics: The dialectic of state and society: Routledge; 2012.
37. Axworthy M. A history of Iran: Empire of the mind: Basic Books; 2016.
38. McAndrew FT. The science of gossip: why we can’t stop ourselves. Scientific American Mind. 2008;19(6):1-5.
39. Hafen S. Organizational gossip: A revolving door of regulation and resistance. Southern Journal of Communication. 2004;69(3):223-240.
40. Kurland NB, Pelled LH. Passing the word: Toward a model of gossip and power in the workplace. Acad Manage Rev. 2000;25(2):428-38.
41. Tian Q-t, Song Y, Kwan HK, Li X. Workplace gossip and frontline employees’ proactive service performance. The Service Industries Journal. 2019;39(1):25-42.
42. McGoldrick M, Giordano J, Garcia-Preto N. Ethnicity and family therapy: Guilford Press; 2005.
43. Attardo S. Linguistic theories of humor: Walter de Gruyter; 2010.
44. Raskin V. Semantic mechanisms of humor: Springer Science & Business Media; 2012.
45. Naghdipour B. Jokes in Iran. Folklore: Electronic Journal of Folklore. 2014; 59(2):105-120.
46. Jalalkamali M, Iranmanesh M, Nikbin D, Hyun SS. An empirical analysis of the effects of humor on communication satisfaction and job performance in international joint ventures in Iran. Journal of Management & Organization. 2018;24(2):295-311.
47. Salingar L. Shakespeare and the Traditions of Comedy: Cambridge University Press; 1974.
49. Khafipour H. The empires of the Near East and India: source studies of the Safavid, Ottoman, and Mughal literate communities: Columbia University Press;2019.
50. Knysh A. Sufism: A New History of Islamic Mysticism: Princeton University Press; 2019.
51. Van Den Bos M. Elements of neo-traditional Sufism in Iran. 2012.
52. Zhao K, Bai ZG, Bo A, Chi I. A systematic review and meta-analysis of music therapy for the older adults with depression. Int J Geriatr Psychiatry. 2016;31(11):1188-98.
53. Randall AJ. Music, power, and politics: Routledge; 2004.
54. Leone M. My schoolmate: Protest music in present-day Iran. Critical Discourse Studies. 2012;9(4):347-62.
55. Khaleghi R. The story of Iranian music. Tehran: Mahoor; 2011.
56. Miller L. Music and Song in Persia (RLE Iran B): The Art of Avaz: Routledge; 2012.
57. Abdoli S, editor Iranian Traditional Music Dastgah Classification. ISMIR; 2011.
58. Babiracki CM, Nettl B. Internal Interrelationships in Persian Classical Music: The Dastgah of Shur in Eighteen Radifs. Asian music. 1987;19(1):46-98.
59. Nooshin L. The song of the nightingale: Processes of improvisation in dastgāh Segāh (Iranian classical music). British Journal of Ethnomusicology. 1998;7(1):69-116.
60. Farhat H. The dastgah concept in Persian music: Cambridge University Press; 2004.
61. Nettl B. Daramad of Chahargah: A study in the performance practice of Persian music: Harmonie Park Press; 1972.
62. Taheri Mirghaed M, Abolghasem Gorji H, Panahi S. Prevalence of Psychiatric Disorders in Iran: A Systematic Review and Meta-analysis. Int J Prev Med. 2020;11:21.
63. Mohamadi K, Ahmadi K, Fathi Ashtiani A, Azad Fallah P, Ebadi A, Yahaghi E. Indicators of mental health in various Iranian populations. Iran Red Crescent Med J. 2014;16(2):e14292.
64. Hashemi N. Charles Taylor’sa secular age and secularization from below in Iran. A. Secular age beyond the West: Religion, law and the state in Asia, the Middle East and North Africa. 2018:185-212.
65. Kao H, Sr., Zhu L, Chao AA, Chen HY, Liu IC, Zhang M. Calligraphy and meditation for stress reduction: an experimental comparison. Psychol Res Behav Manag. 2014;7:47-52.
66. Zhu Z, Wang R, Kao HS, Zong Y, Liu Z, Tang S, et al. Effect of calligraphy training on hyperarousal symptoms for childhood survivors of the 2008 China earthquakes. Neuropsychiatr Dis Treat. 2014;10:977-85.
67. Linesch D. Clinical art therapy and Hebrew calligraphy: An integration of practices. Journal of Clinical Art Therapy. 2014;2(1):5-20.
68. Ekhtiar M. Practice makes perfect: The art of calligraphy exercises (siyāh mashq) in Iran. Muqarnas. 2006;23:107-30.
69. Izadi S, Sadri J, Solimanpour F, Suen CY, editors. A review on Persian script and recognition techniques. Summit on Arabic and Chinese Handwriting Recognition; 2006: Springer.
70. Schimmel A. Calligraphy and Islamic culture: New York University Press;1984.
71. Chen W, Chen C, Yang P, Bi S, Liu J, Xia M, et al. Long-term Chinese calligraphic handwriting reshapes the posterior cingulate cortex: A VBM study. PLoS One. 2019;14(4):e0214917.
72. Seddigh R. Anorgasmia in Iranian Culture: The Queen’s Passivity. Sexuality & Culture. 2021;25(1):347-53.
73. Shariati B, Keshavarz-Akhlaghi AA, Mohammadzadeh A, Seddigh R. The Content Validity of the Cultural Formulation Interview (CFI). Psychiatry J. 2018;2018:3082823.
IssueVol 16 No 4 (2021) QRcode
SectionReview Article(s)
Cross Cultural Comparison Dissociative Disorder Ethnopsychology Iranian Culture

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Seddigh R. Dissociative Disorder in the Iranian Culture: The Lawless Utopia. Iran J Psychiatry. 2021;16(4):462-470.