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Treatment of depersonalization/derealization disorder

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


Depersonalization/derealization disorder (DDD) is characterized by persistent or recurrent depersonalization and/or derealization that causes clinically significant distress. In addition, reality testing remains intact [1].

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.

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).

DDD 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 DDD. The epidemiology, pathogenesis, clinical manifestations, course, and diagnosis of DDD are discussed separately. (See "Depersonalization/derealization disorder: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis".)


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Literature review current through: Sep 2016. | This topic last updated: Aug 28, 2015.
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