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PubMed2002

Instrument to assess depersonalization-derealization in panic disorder.

There is a long history of scholarly interest on depersonalization-derealization (DD) and its role in clinical anxiety, but there is a paucity of appropriate assessment instruments available. Our objective was to develop and evaluate a self-report measure of DD for use with clinically anxious patients. Panic disorder patients (n=169) were surveyed about DD experiences and provided data on a new item pool for psychometric development. DD episodes were common and a 28-item Depersonalization-Derealization Inventory was found to possess good reliability and validity. DD appears to be prevalent and clinically relevant in panic disorder. Continued study of DD is warranted and may be facilitated by the availability of a suitable instrument with promising psychometric properties. A 12-item version of the instrument may be appropriate as a brief screen.

Adult↗
PubMed2003

Basal norepinephrine in depersonalization disorder.

In contrast to the noradrenergic dysregulation described in PTSD, little is known regarding noradrenergic function in dissociative disorders. The purpose of this preliminary study was to investigate basal norepinephrine in depersonalization disorder (DPD). Nine subjects with DSM-IV DPD, without lifetime PTSD, were compared to nine healthy comparison (HC) subjects. Norepinephrine was measured via 24-h urine collection and three serial plasma determinations. Groups did not differ significantly in plasma norepinephrine levels. Compared to the HC group, the DPD group demonstrated significantly higher urinary norepinephrine, only prior to covarying for anxiety. The DPD group also demonstrated a highly significant inverse correlation between urinary norepinephrine and depersonalization severity (r=-0.88). Norepinephrine and cortisol levels (reported in a prior study) were not intercorrelated. We concluded that although dissociation accompanied by anxiety was associated with heightened noradrenergic tone, there was a marked basal norepinephrine decline with increasing severity of dissociation. The findings are in concordance with the few reports on autonomic blunting in dissociation and merit further investigation.

Adult↗
PubMed2001

Hypothalamic-pituitary-adrenal axis dysregulation in depersonalization disorder.

BACKGROUND: The purpose of this preliminary study was to investigate HPA axis function in dissociation. METHODS: Nine subjects with DSM-IV depersonalization disorder (DPD), without lifetime Posttraumatic Stress Disorder (PTSD) or current major depression, were compared to nine healthy comparison (HC) subjects of comparable age and gender. RESULTS: DPD subjects demonstrated significant hyposuppression to low-dose dexamethasone administration and significantly elevated morning plasma cortisol levels when covaried for depression scores, but no difference in 24-hour urinary cortisol excretion. Dissociation scores powerfully predicted suppression whereas depression scores did not contribute to the prediction. CONCLUSIONS: Primary dissociative conditions, such as depersonalization disorder, may be associated with a pattern of HPA axis dysregulation that differs from PTSD and merits further study.

Adult↗
PubMed2001

Depersonalization disorder: thinking without feeling.

Patients with depersonalization disorder (DP) experience a detachment from their own senses and surrounding events, as if they were outside observers. A particularly common symptom is emotional detachment from the surroundings. Using functional magnetic resonance imaging (fMRI), we compared neural responses to emotionally salient stimuli in DP patients, and in psychiatric and healthy control subjects. Six patients with DP, 10 with obsessive-compulsive disorder (OCD), and six volunteers were scanned whilst viewing standardized pictures of aversive and neutral scenes, matched for visual complexity. Pictures were then rated for emotional content. Both control groups rated aversive pictures as much more emotive, and demonstrated in response to these scenes significantly greater activation in regions important for disgust perception, the insula and occipito-temporal cortex, than DP patients (covarying for age, years of education and total extent of brain activation). In DP patients, aversive scenes activated the right ventral prefrontal cortex. The insula was activated only by neutral scenes in this group. Our findings indicate that a core phenomenon of depersonalization--absent subjective experience of emotion--is associated with reduced neural responses in emotion-sensitive regions, and increased responses in regions associated with emotion regulation.

Adult↗
PubMed2001

Depersonalization, self-esteem and body image in male-to-female transsexuals compared to male and female controls.

Whether postoperative male-to-female transsexuals differ in regard to measures of self- and body image from a nontranssexual control group was investigated. A group of 30 postoperative male-to-female transsexuals and control groups of 30 males and 30 females completed self-report measures (depersonalization, self-esteem, gender identity traits, body image). Results showed that transsexuals and males scored higher on self-esteem and dynamic body image than the females did. No differences between the groups were found in terms of depersonalization and satisfaction. Transsexuals and females described themselves as more feminine than males. Regarding sex-role orientation, more androgynous subjects were found among transsexuals than in the control groups. General satisfaction is associated with feminine and masculine traits in transsexuals. Results are discussed in context of the function of these personality features for the identity development of male-to-female transsexuals.

Adult↗
PubMed2006

[Visual distortions and depersonalization-de-realization syndrome].

Disturbances of visual perception like micropsia, macropsia, teleopsia, pelopsia, metamorphopsia or loss of stereoscopic depth perception are usually considered in ophthalmology as symptoms of retinopathy, especially maculopathy or disorders of binocularity. Differential diagnostic considerations include disorders like migraine and epilepsy but not the visual disturbance pertaining to the depersonalization-de-realization syndrome, although the above-mentioned symptoms are more prevalent in this psychogenic disorder. This article gives a review of depersonalization-de-realization in order to enable the ophthalmologist to include this syndrome into his diagnostic considerations.

Depersonalization↗
PubMed1977

Depersonalization in accident victims and psychiatric patients.

A transient depersonalization syndrome was identified in nearly one third of persons exposed to life-threatening danger (accident victims) and close to 40% of a group of hospitalized psychiatric patients. Although the syndrome was similar in these populations, mental clouding developed more commonly among patients and alertness was more prominent among accident victims. Anxiety was significantly associated with the development of depersonalization among psychiatric patients and was almost certainly a factor in its appearance among accident victims. The findings suggest that this syndrome is a specific response to extreme danger or its associated anxiety.

Accidents, Traffic↗
PubMed1978

Depersonalization in a 16-year-old boy.

A prolonged period of depersonalization resolved in this 16-year-old boy with only supportive therapy. Reasons for the depersonalization and withholding of other treatment are discussed. Observations are shared of the very intriguing phenomenon of derealization and allied conditions, psychiatric syndromes which are appearing with increasing frequency among so-called "normal adolescents" who indulge in drugs or other experiences which alter the state of consciousness, and among adolescents who survive disasters or harrowing experiences.

Adult↗
PubMed2003

Examination of the pathological dissociation taxon in depersonalization disorder.

In recent years, the pathologic dissociation taxon developed by Waller, Putnam, and Carlson (Psychological Methods 1:300-321, 1996) from a Dissociative Identity Disorder (DID) sample has been increasingly used in studies of dissociation in general. However, the taxon's convergence with dissociative diagnoses other than DID, as well as the taxon's central premise that pathologic dissociation is a categorical rather than a dimensional construct, remain areas of exploration. This report examines the applicability of the pathologic dissociation taxon to Depersonalization Disorder (DPD). The Dissociative Experiences Scale was administered to 100 consecutively recruited DPD subjects diagnosed by semistructured clinical interview and by the SCID-D. Taxon membership probability was calculated using the recommended SAS scoring program. Approximately 2/3 of subjects (N = 64) had a very high probability (>.80) of belonging to the taxon, while 1/3 of subjects had a very low probability (<.10) of belonging to the taxon. A taxon cutoff score of 13 yielded an 81% sensitivity in detecting the presence of DPD. The modest convergence between taxonic membership and clinical dissociative disorder diagnosis suggests that the taxon may have important limitations in its use, at least when applied to DPD in its current form. As previously, we continue to recommend a low taxon cutoff score (13) for the sensitive detection of depersonalization disorder. The inference that pathologic dissociation is a unitary and categorical entity is also discussed.

Adult↗
PubMed1999

Regional cerebral blood flow and depersonalization after tetrahydrocannabinol administration.

OBJECTIVE: The aim of this study was to examine the relationship between depersonalization induced by tetrahydrocannabinol (THC), and regional brain activation. METHOD: Cerebral blood flow (CBF) was measured by means of positron emission tomography (PET) in 59 normal right-handed volunteers before and following intravenous infusions of THC. RESULTS: After THC, CBF showed a global increase which was more marked in the right hemisphere, frontal lobes and anterior cingulate. CONCLUSION: Regression analyses showed positive correlations between the right frontal and anterior cingulate and depersonalization.

Adult↗
PubMed2005

[Depersonalization--current data].

OBJECTIVE: Depersonalization is a fascinating clinical phenomenon referring to a self-consciousness disorder, characterized by emotional detachment from one's own feelings, thoughts, or actions. This article intends to summarize the current literature in this area. METHOD: Using the Medline data base, we reviewed literature addressing the clinical, etiology, nosology, physiopathology, and treatment of depersonalization. CONCLUSIONS: Derealization means that perception of the world and of external reality are altered. These 2 phenomena are often associated. They are not specific to any psychiatric entity and are reported in many different psychiatric syndromes. Many factors, including use of different substances, are involved in their onset. The physiopathology is still little known. However, some conceptual models suggest partial amygdala inhibition combined with activation of other amygdaloid structures. A serotoninergic functioning impairment is indicated in different pharmacologic studies. Different psychotropic drugs, especially serotoninergic antidepressants, have been proposed for pharmacotherapy; however, there are no conclusive randomized studies, and the contribution of psychotherapy in treating these patients is still questioned.

Amygdala↗
PubMed1998

Depersonalization in kindergarten teachers in relation to rejection of help by fellow teachers and emotional support from family.

The present study investigated the external validity of a model describing the reactions of spurned helpers by examining the relation of spurning with burnout among kindergarten teachers. A second objective was to explore whether emotional support from one's family could reduce the negative effects of feeling spurned on burnout. 48 kindergarten teachers in Macau responded to a questionnaire measuring feeling spurned, emotional support from family, and depersonalization. Analyses indicated the effects of feeling spurned on depersonalization and also the benefit of emotional support; however, no evidence was obtained for he proposed buffering effect of emotional support.

Adult↗
PubMedDate not supplied

Incidence and correlates of depersonalization following head trauma.

Using the criteria of the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D), we assessed the incidence of feelings of unreality among a sample of 70 persons who had sustained head injuries. Among those whose head trauma could be classified as mild, more than 60% complained of a depersonalization syndrome. Among those with a significant period of unconsciousness, only 11% had similar complaints. There was a high comorbidity with post-traumatic stress disorder and vertigo. Feelings of unreality were not associated with cognitive impairment or elevated personality test scores, nor were there significant relationships with gender or involvement in litigation. A conservative estimate of incidence of depersonalization among persons with minor head trauma is 13%, while, at the upper end, as many as 67% of persons who sustain mild head injury may experience feelings of unreality.

Adolescent↗
PubMed1976

Imaginary companions, fantasy twins, mirror dreams and depersonalization.

Illustrative case material is presented to demonstrate genetic linkages between the presence of imaginary companions or fantasy twins and extensive mirror play in childhood and early adolescence, and the appearance of mirror dreams and depersonalization in later adolescence and adulthood. The defensive splitting of the self-representations observable in these phenomena is viewed as a means of warding off castration anxiety and anxiety about object loss, anxieties which arise because of conflicts primarily centering on intense aggressive drive derivative wishes. Formulations about depersonalization are discussed.

Adult↗
PubMed2000

[High performance liquid chromatography of corticosteroids in patients with depression and depersonalization].

Six corticosteroids were measured by high performance microcolumn reverse-phase liquid chromatography in patients with the depressive syndrome and depersonalization. Changes in the blood concentrations of hydrocortisone, cortisone, and corticosterone were revealed. The method is recommended as an additional tool for the differential diagnosis of depressions and depersonalization.

Adult↗
PubMed2005

[Depersonalization after withdrawal from cannabis usage].

The phenomenon of depersonalization during cannabis usage (intoxication) is commonly known. However, its appearance after drug stoppage is relatively unknown. This article reviews the literature on depersonalization after cannabis withdrawal and discusses three representing cases demonstrating the severity of the problem. Clinical features are described as well as effects on functioning and the long-term nature of this disorder. The treatment approach in each case is also presented.

Anxiety Disorders↗
PubMed1991

[Depersonalization and déjà vu experiences: prevalences in nonclinical samples].

According to the relevant psychological and psychiatric literature, depersonalization and déjà vu experiences are usually viewed as symptoms of severe psychiatric or neurological disorders, especially in schizophrenia, depression and epilepsy. Studies of these phenomena in non-clinical populations are rate. In this article we present the results of several epidemiological investigations. On the basis of survey and interview research, quantitative and qualitative aspects of both phenomena were assessed, as well as the relations with personality variables like emotionality. The results indicate prevalence rates up to 80 percent in non-clinical populations. Based on epidemiological considerations, the question of differentiation between clinical and non-clinical forms of depersonalization and déjà vu is discussed.

Adolescent↗
PubMed1990

[Study of pain sensitivity based on the indicators of electro- odontometry in patients with depersonalization and depressive disorders].

Electroodontometry was used to examine the pain threshold and sensation threshold in patients with depersonalization, endogenous depression and in mentally healthy test subjects. The strongest differences in the thresholds were found on the anterior teeth. The patients with depersonalization manifested a considerable rise of the sensation threshold and to an ever greater degree of the pain threshold. In patients suffering from endogenous depression, both thresholds were decreased and coincided almost completely. It is likely that this fact is associated with a relatively higher incidence of the painful syndrome in patients suffering from depression.

Adolescent↗