Depersonalization recovery process series#

This article reviews the English-language literature documenting depersonalization and/or derealization in patients with an underlying organic condition (not attributable to substance abuse or intoxication) and presents four new cases of organic depersonalization. 1, 12 However, the validity of this construct has been argued. Furthermore, a preexisting diagnosis of an organic disorder precludes the diagnosis. According to the diagnostic criteria, however, the disorder must not occur exclusively during the course of another mental disorder and must not be due to the effects of a drug (prescribed or illicit). 1 The syndrome tends to begin in adolescence and characteristically has a chronic course, although the intensity of the symptoms may vary. 1 The diagnostic criteria are similar in ICD-10 however, in this system, derealization is included along with DP, 12 whereas it is classified separately as a variant of “dissociative disorder not otherwise specified” in DSM-IV. 6– 11 The symptoms tend to be transient and of short duration however, they may persist and develop into the syndrome of depersonalization disorder, which can be diagnosed when persistent or recurrent episodes of DP cause distress and occur in the presence of intact reality testing. 1 DP and DR are commonly reported in the general population 3– 5 and in patients with a variety of psychiatric disorders.

1 Although these symptoms are classified separately under dissociative disorders in the DSM-IV, they often coexist, 2 and both consist of altered perceptions of the self and the environment. The symptom of depersonalization (DP) has been defined in DSM-IV as an experience of feeling detached from and as if an outside observer of one's mental processes or body, while maintaining intact reality testing derealization (DR) has been defined as the sensation that the external world is strange or unreal. The introduction to the DSM-IV of an organic subtype of depersonalization disorder would facilitate research in this area. Left-sided temporal lobe dysfunction and anxiety are suggested as factors in the development of depersonalization however, further studies are needed to determine the relationship. Epilepsy and migraine appear to be the disorders most commonly associated with depersonalization.

Depersonalization recovery process series#

Information from case series documenting depersonalization in the context of medical illnesses is also presented and the underlying etiology discussed. The authors present 4 new cases of depersonalization in patients with an underlying organic condition, along with 47 cases from the literature in which the available information permits diagnosis of organic depersonalization.

The symptoms have also been described in patients with a primary psychiatric or organic diagnosis, where their secondary status precludes a DSM-IV diagnosis of depersonalization disorder. Depersonalization and derealization are commonly reported in the general population as a response to stress.