Treatment of depersonalization derealization disorder
- Daphne Simeon, MD
Daphne Simeon, MD
- Associate Clinical Professor
- Mount Sinai School of Medicine
The persistence or recurrence of depersonalization and/or derealization that causes clinically significant distress or impairment in the presence of intact reality testing is referred to as depersonalization derealization disorder (DDPD) .
●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 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.
●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).
DDPD has a prevalence of approximately two percent and is associated with significant morbidity, but often goes undetected or misdiagnosed, leading to delays in treatment.
This topic discusses treatment of DDPD. The epidemiology, pathogenesis, clinical manifestations, course, and diagnosis of DDPD are discussed separately. (See "Depersonalization derealization disorder: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis".)
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- GENERAL PRINCIPLES
- Psychodynamic therapy
- - Conceptual model
- - Intervention
- - Efficacy
- - Administration
- Cognitive behavioral therapy
- - Intervention
- - Efficacy
- - Administration
- Supportive psychotherapy for chronic DPD
- Serotonin reuptake inhibitors
- Antipsychotic medications
- SUMMARY AND RECOMMENDATIONS