Dissociative Disorders

Diagnostic Criteria
According to the DSM-IV-TR (2000), Depersonalization Disorder is characterized by persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one's mental processes or body (Criterion A). Furthermore, the individual may feel as if he/she is an automaton or living in a dream/illusion. The sensation of being an outside observer may induce various types of sensory anesthesia, lack of affective response, and lack of control over actions and speech (APA, 2000).

During the depersonalization experience, reality testing remains intact (Criterion B) (APA, 2000). Differentiation between depersonalization with that of schizophrenia is intact reality testing with the former and not the latter. For example, the feeling of being detached from one's actions or lack of control is within one's awareness. A person still identifies with his/her own reality, but has a general feeling of going "crazy" or objects seem strange and foreign (APA, 2000).

Depersonalization symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion C) (APA, 2000).

The depersonalization episode does not occur exclusively during the course of another mental disorder, such as schizophrenia, panic disorder, acute stress disorder, or another dissociative disorder, and is not due to the physiological effects of a substance or a general medical condition (Criterion D) (APA, 2000).

References:

American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Arlington, VA: American Psychiatric Association.

Prevalence
According to the DSM-IV-TR (2000), lifetime prevalence in community and clinical seeting is unknown. However, according to Sadock & Sadock (2007), experiences of depersonalization are extremely common accounting for the third most reported psychiatric symptom behind depression and anxiety. In addition, one survey found a one-year prevalence of 19% in the gneral population. Aderibigbe, Bloch, and Waler (2001) found a estimated one-year prevalence of 23% in the general poulation (as cited in Simeon, 2004). Ross (1991) suggested a 2.4% life-time prevalence rate in the general poulation (as cited in Simeon, 2004).

The DSM-IV-TR (2000) states that transient experience of depersonalization develops in nearly one-third of individuals exposed to life-threatening danger and in close to 40% of individuals hosptialized for mental disorders.

References:

American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders. Arlington, VA: American Psychiatric Association.

Sadock, B., & Sadock, V. (2007). Synopsis of Psychiatry (10th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Simeon, D. (2004). Depersonalisation disorder: A contemporary overview. CNS Drugs, 18(6), 343-354. Retrieved from http://web.ebscohost.com

Course
Accoring to the DSM-IV-TR (2000), age 16 is the mean onset of depersonalization disorder. Recurrent Depersonalization is rarely the presenting problem as anxiety, panic, and depression are often reported initially. The duration of depersonalization disorder is typically chronic; however, episodes may vary from brief (a couple of seconds) to persistent (a couple of years) (APA, 2000). Depersonalization is a common dissociative experience in response to exposure to trauma or life-threatening situations. Thus, trauma histories are common amongst depersonalization sufferers (APA, 2000).

Transient Depersonalization may be related to history of siezure and migrain sufferers; and in response to the use of psychedelic drugs (i.e. LSD, Mescaline) (Sadock & Sadock, 2007). Chronic sufferers of depersonalization as opposed to transient episodies, tend to have severe impairments in occupational, social, and personal functioning.

References:

American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Arlington, VA: American Psychiatric Association.

Sadock, B., & Sadock, V. (2007). Synopsis of Psychiatry (10th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Articles
The role of childhood interpersonal trauma in DD.pdf

On Becoming One-Self Reflections.pdf

Media Links
Depersonalization Disorder ppt.pdf

Dissociative Identity Disorder.pdf