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Psychotherapy of depersonalization/derealization disorder

Author
Daphne Simeon, MD
Section Editor
David Spiegel, MD
Deputy Editor
Richard Hermann, MD

INTRODUCTION

Depersonalization/derealization disorder (DDD) is characterized by persistent or recurrent depersonalization and/or derealization that causes clinically significant distress. Reality testing remains intact [1]. DDD has a prevalence of approximately 2 percent and is associated with significant morbidity, but often goes undetected or misdiagnosed, leading to delays in treatment.

This topic discusses psychotherapy for DDD. The epidemiology, pathogenesis, clinical manifestations, course, and diagnosis of DDD are discussed separately. Pharmacotherapy for DDD is also discussed separately. (See "Depersonalization/derealization disorder: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis" and "Pharmacotherapy of depersonalization/derealization disorder".)

DEFINITIONS

Depersonalization — Depersonalization is a persistent or recurrent feeling of detachment or estrangement from one’s self. An individual experiencing depersonalization may report feeling like an automaton or as if in a dream or as if watching himself or herself in a movie. Depersonalized individuals may report the sense of being an outside observer of their mental processes or their body. They often report feeling a loss of control over their thoughts, perceptions, and actions. (See "Depersonalization/derealization disorder: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis", section on 'Clinical manifestations'.)

Derealization — Derealization is a subjective sense of detachment or unreality regarding the world around them (eg, individuals or objects are experienced as unreal, dreamlike, foggy, lifeless, or visually distorted). (See "Depersonalization/derealization disorder: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis", section on 'Clinical manifestations'.)

APPROACH TO TREATMENT

Our approach to selecting among treatments for depersonalization/derealization disorder, including the use of pharmacotherapy and psychotherapy, is discussed separately.

                  

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Literature review current through: Jan 2017. | This topic last updated: Mon Feb 13 00:00:00 GMT 2017.
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References
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