depersonalization/derealization disorder

Depersonalization and derealization symptoms are often transient. Recurrent and persistent symptoms can result in a diagnosis of depersonalization/derealization disorder (DDD). Here, we reported a case of a 24-year-old adult male whose presentation was consistent with primary derealization disorder only. He was referred with his consent by an ophthalmologist and neurologist for psychiatric opinion for the complaints of blackish discoloration of his vision for the last two years and feeling of unreality towards his surroundings for the last one and a half years in the absence of any comorbid physical illness and mental disorder...

OBJECTIVE: Traumatic experiences are a significant risk factor for psychological disturbances, including disorders such as complex posttraumatic stress disorder, emotion-processing problems, and trauma-related dissociative experiences. The present investigation examined the coexistence of these symptoms using a network analysis model. METHOD: This study included a sample of 406 people referred to comprehensive health centers in Tehran from September to December 2023 with psychopathological syndromes...

Background and objective: The current study aimed to investigate the within-day symptom dynamics in PTSD patients, specifically focusing on symptoms that most predict changes in other symptoms. The study included a baseline diagnostic assessment, followed by an assessment using the experience sampling method (ESM) via a smartphone. Method: Participants answered questions related to their PTSD symptoms four times per day for 15 consecutive days (compliance rate 75%). The clinical sample consisted of 48 treatment-seeking individuals: 44 with PTSD as a primary diagnosis, and four patients with subsyndromal PTSD, all of whom had not yet begun trauma-focused treatment...

BACKGROUND: Sexual risk behavior in patients diagnosed with borderline personality disorder (BPD) is supposed to be associated with traumatic experiences and dissociative symptoms. Nevertheless, scientific research thereon is scarce which might be due to the high prevalence of sexual trauma and fear of overwhelming patients with explicit sexual content. METHODS: We investigated a clinical sample of patients diagnosed with BPD (n = 114) and compared them to a sample of matched healthy controls (HC) (n = 114) concerning the dissociative symptoms derealization, depersonalization, and conversion in sexual situations...

OBJECTIVE: This study examined etiological factors and symptom triggers of functional motor symptoms (FMS) or functional seizures (FS) and assessed potential relationships with relevant clinical features (i.e., functional symptoms, quality of life, and general functioning). METHODS: Seventeen participants with FMS or FS and 17 healthy control participants underwent an in-depth clinical interview and completed questionnaires assessing adverse life events, psychological and physical symptoms, alexithymia, autistic traits, illness perceptions, health-related quality of life (HRQoL), and work and social functioning...

BACKGROUND: Symptoms of depersonalization (DP) and derealization (DR) are a risk factor for more severe impairment, non-response to various treatments, and a chronic course. In this study, we investigated the effects of DP/DR symptoms in patients with clinically significant depressive symptoms on clinical characteristics and various outcomes in a representative population-based sample with a 5-year follow-up. METHODS: The middle-aged sample comprised n = 10,422 persons at baseline, of whom n = 9,301 were free from depressive and DP/DR symptoms...

BACKGROUND: Depersonalization and derealization can occur not just from psychiatric causes but also from various organic etiologies, such as seizures and intracerebral structural abnormalities. However, there have been no previous reported cases to the authors' knowledge detailing isolated depersonalization and derealization in the absence of clinical seizure activity or other psychiatric pathology, as sequelae of structural intracerebral lesions. CASE PRESENTATION: In this case report, we detail the unique presentation of a 68-year-old woman under the care of palliative medicine who experienced depersonalization and derealization secondary to a metastatic lesion in her temporal lobe, in the parahippocampal gyrus to medial occipitotemporal gyrus region...

OBJECTIVE: To study psychopathological structure characteristics of depersonalization depression in young women and nonsuicidal autoaggressive and suicidal behavior characteristics in these states. MATERIAL AND METHODS: We studied 36 adolescent female patients (16-25 years) with endogenous depression (F31.3-4; F34.0; F21.3-4+F31.3-4; F60.X+F31.3-4), whose clinical picture was dominated by depersonalization disorders represented by their auto-, allo-, and somatopsychic forms or combinations...

Dissociative symptoms, such as depersonalization and derealization, are experienced by about half of individuals with posttraumatic stress disorder (PTSD). Theoretical models propose that acute dissociation is accompanied by specific behavioral, physiological, and experiential alterations and contributes to unfavorable PTSD symptom course. Yet, empirical evidence is scarce. Here, we explored associations between dissociative and behavioral, physiological, and experiential threat responses as well as effects of dissociative responding on PTSD symptom course...

OBJECTIVE: The dissociative subtype of posttraumatic stress disorder (PTSD) was incorporated into the diagnostic criteria for PTSD in Diagnostic and Statisical Manual of Mental Disorders , Fifth Edition (DSM-5). The subtype requires the presence of persistent or recurrent depersonalization or derealization; however, several authors have suggested that a broader array of dissociative symptoms could be included in the criteria. The objective of the present study was to gather data on a wide range of dissociative symptoms in a sample of highly traumatized individuals...

Depersonalisation-Derealisation Disorder (DDD) has a prevalence of around 1% but is under-recognised and often does not respond to medical intervention. We report on a clinical audit of 36 participants with a diagnosis of chronic DDD who were sequentially recruited from a specialist DDD National Health Service clinic in London, United Kingdom, and who completed Cognitive Behavioural Therapy specifically adapted for DDD. The sample population had a mean age of 38.7 years (s.d. = 13.4), 61% were male and 69% were of White ethnicity...

BACKGROUND: Dissociative identity disorder and depersonalization-derealization have attracted research and clinical interest, facilitating greater understanding. However, little is known about the experience of multiplicity of self outside of traumagenic or illness constructs. Consequently, this systematic review explored how people identifying as having multiple selves conceptualize their experiences and identity. METHODS: A comprehensive search of qualitative studies reporting lived experiences of multiplicity was conducted through PsycINFO, PubMed and Scopus (PROSPERO ID: CRD42021258555)...

The Dissociative Symptoms Scale (DSS) was developed to assess moderately severe types of dissociation (depersonalization, derealization, gaps in awareness and memory, and dissociative reexperiencing) that would be relevant to a range of clinical populations, including those experiencing trauma-related dissociation. The current study used data from 10 ethnically and racially diverse clinical and community samples ( N = 3,879) to develop a brief version of the DSS (DSS-B). Item information curves were examined to identify items with the most precision in measuring above average levels of the latent trait within each subscale...

Fear extinction is the basis of exposure therapies for posttraumatic stress disorder (PTSD), but half of patients do not improve. Predicting fear extinction in individuals with PTSD may inform personalized exposure therapy development. The participants were 125 trauma-exposed adults (96 female) with a range of PTSD symptoms. Electromyography, electrocardiogram, and skin conductance were recorded at baseline, during dark-enhanced startle, and during fear conditioning and extinction. Using a cross-validated, hold-out sample prediction approach, three penalized regressions and conventional ordinary least squares were trained to predict fear-potentiated startle during extinction using 50 predictor variables (5 clinical, 24 self-reported, and 21 physiological)...

This paper presents a critical comparison between two phenomenological accounts of schizophrenic experience: on the one side, Blankenburg's seminal work on the basal disturbance ( Grundstörung ) of schizophrenia as loss of natural self-evidence ( Natürlichen Selbstverständlichkeit ); on the other side, Tatossian's insight, briefly elaborated in a lecture presented in Heidelberg in 1994 and largely forgotten by the relevant literature. Whereas the former mainly develops an intersubjective reading of schizophrenia, the latter suggests an intrasubjective understanding...

Dissociation is a "disruption of the usually integrated functions of consciousness, memory, identity or perception of the environment" according to DSM-5.  It is commonly seen in psychiatric disorders including primary dissociative disorders, post-traumatic stress disorder, depression, and panic disorder. Dissociative phenomena are also described in the context of substance intoxication, sleep deprivation and medical illnesses including traumatic brain injury, migraines, and epilepsy. Patients with epilepsy have higher rates of dissociative experiences as measured on the Dissociative Experiences Scale compared to healthy controls...

Depersonalization-derealization disorder (DPD) is characterized by persistent or recurrent experiences of detachment from oneself and surroundings, as well as a sense of unreality. Considering the inadequacy of current research on treatment, we performed a systematic review of the available pharmacotherapies, neuromodulations, and psychotherapies for DPD. The systematic review protocol was based on PRISMA 2020 guidelines and pre-registered. The PubMed, Web of Science, PsycINFO, Embase, the Cochrane Library, Scopus, and ScienceDirect databases were searched from inception to June 2021...

Appraisal of trauma is a critical factor in the development of impairing post-traumatic stress symptoms, such as dissociation. Individuals may appraise trauma as morally injurious (i.e., moral injury exposure [MIE]) and experience subsequent moral distress related to this exposure (i.e., moral injury distress [MID]). To date, however, investigation into the relations between moral injury appraisals and dissociation has been limited, particularly within community populations. This study investigated MIE and MID in relation to six facets of dissociation (disengagement, depersonalization, derealization, memory disturbances, emotional constriction, identity dissociation) in a sample of trauma-exposed community members ( n  = 177, 58...

BACKGROUND: Dissociation is a ubiquitous clinical phenomenon. Dissociative disorders (DD) are primarily characterized by dissociation, and dissociative states are also a criterion for borderline personality disorder (BPD) and the dissociative subtype of post-traumatic stress disorder (PTSD). Dissociative reactions (e.g., depersonalization/derealization or gaps in awareness/memory) across diagnostic categories are believed to be affect contingent and theorized to serve affect regulation functions...

Background: Racial discrimination is a traumatic stressor that increases the risk for posttraumatic stress disorder (PTSD), but mechanisms to explain this relationship remain unclear. Peritraumatic dissociation, the complex process of disorientation, depersonalization, and derealization during a trauma, has been a consistent predictor of PTSD. Experiences of frequent racial discrimination may increase the propensity for peritraumatic dissociation in the context of new traumatic experiences and contribute to PTSD symptoms...