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Depersonalization/derealization disorder: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis

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


Depersonalization/derealization disorder (DDD) is characterized by the persistence or recurrence of depersonalization and/or derealization that cause clinically significant distress or impairment in the presence of intact reality testing [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 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 the epidemiology, pathogenesis, clinical manifestations, course, and diagnosis of DDD. Treatment of DDD is discussed separately. (See "Psychotherapy of depersonalization/derealization disorder".)

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Literature review current through: Nov 2017. | This topic last updated: Aug 27, 2015.
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