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Depersonalization/Derealization Disorder

Overview

  • Recurrent episodes in which a person has sensations of unreality of one’s own body or surroundings

  • Feelings dominate and interfere with life functioning

  • Only diagnosed if primary problem involves depersonalization and derealization

    • Similar symptoms may occur in the context of other disorders, including panic disorder and PTSD

DSM-5 Criteria

  • Persistent or recurrent experiences of depersonalization, derealization, or both

  • Reality testing is intact

  • Symptoms cause significant distress

  • Not result of substance us

  • Not better explained otherwise

Features

  • Cognitive deficits in attention, short-term memory, spatial reasoning

  • Easily distractable

  • Difficulty absorbing new information

  • Reduced emotional responding

  • May have dysregulation of HPA axis in brain

Facts and Statistics

  • High comorbidity with anxiety and mood disorders

  • 1 to 3% of the population

  • Onset is typically in adolescence

  • Usually runs a lifelong chronic course

  • Having a history of trauma makes this disorder more likely to manifest

Treatment

  • Research is very scarce

  • No systematic research on psychological treatments

  • Trial of antidepressant (Prozac) showed no effect above placebo

Depersonalization/Derealization Disorder

Overview

  • Recurrent episodes in which a person has sensations of unreality of one’s own body or surroundings

  • Feelings dominate and interfere with life functioning

  • Only diagnosed if primary problem involves depersonalization and derealization

    • Similar symptoms may occur in the context of other disorders, including panic disorder and PTSD

DSM-5 Criteria

  • Persistent or recurrent experiences of depersonalization, derealization, or both

  • Reality testing is intact

  • Symptoms cause significant distress

  • Not result of substance us

  • Not better explained otherwise

Features

  • Cognitive deficits in attention, short-term memory, spatial reasoning

  • Easily distractable

  • Difficulty absorbing new information

  • Reduced emotional responding

  • May have dysregulation of HPA axis in brain

Facts and Statistics

  • High comorbidity with anxiety and mood disorders

  • 1 to 3% of the population

  • Onset is typically in adolescence

  • Usually runs a lifelong chronic course

  • Having a history of trauma makes this disorder more likely to manifest

Treatment

  • Research is very scarce

  • No systematic research on psychological treatments

  • Trial of antidepressant (Prozac) showed no effect above placebo

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