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PubMed2004

[Autopractice, derealization, activation, and the subject of will].

A more precise definition of control functions should serve to supplement, correct, and complete what has previously been written about the structural dynamic approach. Prehuman stages of development involve autopractical drives and their instinctive inhibition and activation. The human stage involves a differentiation in the direction of drives. A human being's own autopractice remains the moving force, the moving principle. Inhibition and activation have become incorporated in the development of interiority and its structural basis and have freed themselves from instinctual dependency. Little has changed regarding the function of activation. Inhibition has made its way into the realm of the function of derealization; it intervenes as a regulatory principle in human autopractice. The paper concludes with a look at the topic of the will in which it discusses the interplay among the functions of human autopractice, derealization, and activation.

Awareness↗
PubMed2005

[Out-of-body experience as possible seizure symptom in a patient with a right parietal lesion].

Out-of-body experiences are reported in a variety of diseases and physiologic conditions. We report a 44-year-old patient with epigastric auras, psychomotor and grand mal seizures, and paroxysmal experiences during which he believed to have left his body and seen himself from the outside. Electroencephalography showed a right temporal and right parietal seizure pattern on several occasions, and a lesion in the right parietal lobe was detected by cranial magnetic resonance imaging. Histological examination showed a pleomorphic xanthoastrocytoma. Following extirpation of the lesion, the patient has been seizure-free for 5 years.

Adult↗
PubMed2005

[Dissociative disorders].

There are problems with dissociative and conversion disorders with respect to classification, diagnosis, and therapeutic strategies which can only be understood in the historic context of hysteria. Even current diagnostic systems such as the DSM-IV and ICD-10 differ in the classification of such disorders. High prevalence rates ranging from 3% in the general population to 30% in clinical samples underscore their clinical relevance, and traumatic experiences play a major role in the pathogenesis. High rates of comorbid psychiatric disorders, the tendency to chronicity, and concepts of somatization (particularly in patients with conversion disorders) complicate psychotherapeutic approaches. Depending on the treatment goals, both psychodynamic and cognitive-behavioral methods can be applied, supplemented by specific techniques from trauma therapy, e.g. EMDR.

Cognitive Behavioral Therapy↗
PubMed1998

[Dysmorphophobia. Becoming estranged with oneself as a disorder of communication].

Dysmorphophobia shall be described as an example for a communicative disorder and be deliminated from other syndromes under which it has been subsumed so far. On the background of available literature, the "fear of deformity" is to be elaborated as feeling ashamed of the contemptuous look of another person, whose look has turned into the own view. This results in a discrepancy with the ego and the own self conveyed by others, finally leading to depersonalisation. This basic interpersonal appearance shall be further illustrated by two individual examples.

Adult↗
PubMed2004

The epidemiology of depersonalisation and derealisation. A systematic review.

BACKGROUND: Symptoms of depersonalisation (DP) and derealisation (DR) are increasingly recognised in both clinical and non-clinical settings, but their importance and underlying pathophysiology is only now being addressed. METHODS: This paper is a systematic review of the current state of knowledge about the prevalence of depersonalisation and derealisation using computerised databases and citation searches. All potential studies were examined and numerical data included. Three categories of study are reviewed: questionnaire and interview surveys of selected student and non-clinical samples; population-based community surveys using standardised diagnostic interviews; and clinical surveys of depersonalisation/derealisation symptoms occurring within inpatients with psychiatric disorders. In addition, we present newly analysed data of the prevalence of depersonalisation/derealisation from five large population-based studies. RESULTS: Epidemiological surveys demonstrate that transient symptoms of depersonalisation/derealisation in the general population are common, with a lifetime prevalence rate of between 26 and 74% and between 31 and 66% at the time of a traumatic event. Community surveys employing standardised diagnostic interviews reveal rates of between 1.2 and 1.7 % for one month prevalence in a UK sample and a 2.4% current prevalence rate in a Canadian sample. Current prevalence rates in samples of consecutive inpatient admissions are reported between 1 and 16%, although screening measures employed may have resulted in these being an underestimate. Prevalence rates in clinical samples of specific psychiatric disorders vary between 30% of war veterans with PTSD and 60% of those with unipolar depression. There is a high prevalence within panic disorder with rates varying from 7.8 to 82.6%. DISCUSSION: DP and DR symptoms are common in normal and psychiatric populations, but prevalence estimates are hampered by inconsistent definitions and the use of variable time-frames. Population-based surveys using diagnostic interviews yield prevalence rates of clinically significant DP/DR in the region of 1-2%. Surveys of clinical populations in which common screening and assessment instruments were used also yield consistently high prevalence rates. The use of reliable diagnostic assessments and rating scales is needed. The relationship between DP/DR and certain other psychiatric disorders (e. g. panic) suggests possible common pathophysiological or aetiological factors.

Adult↗