Depersonalization Disorder: Diagnosis and Treatment

Derealization or depersonalization is characterized by feelings that the objects of the external environment are changing shape and size, or that people are automated and inhuman, and features detachment as a major defense. Depersonalization disorder usually begins in adolescence; typically, patients have continuous symptoms. Onset can be sudden or gradual. An estimated 2.4% of the general population meets the diagnostic criteria for this disorder. However, the prevalence rate is questioned by many clinicians and may be lower. This disorder frequently coexists with mood, anxiety, and psychotic disorders.

Mental status

The DSM-IV defines depersonalization disorder as the occurrence of persistent or recurrent episodes of depersonalization and/or derealization that are not related to any other mental disorder and cause marked distress.

Depersonalization is defined as persistent or recurrent experiences of feeling detached, as if one is an outside observer of one's mental processes or body. Results from reality testing are usually normal during the experience. The episodes cause clinically significant distress and/or impairment in social, occupational, and other main areas of functioning. The depersonalization does not occur exclusively during the course of another mental disorder and is not due to direct effects of substance abuse or general medication.

Treatment of Depersonalization Disorder

Unfortunately, at this time, a specific and effective treatment plan has not been developed for depersonalization disorder. Studies show that psychotherapy and medications are not effective. Reports indicate that some patients respond to selective serotonin reuptake inhibitors or benzodiazepines. Further studies are needed to find an effective treatment regimen. At his time, the most viable treatment is to assist the patient in achieving comfort and stability, away from traumatic interactions.

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Reviewed: 04/2006