1ĭepersonalization/derealization disorder is classified clS el dissociative disorder. Patients who receive treatment interventions that address their trauma-based dissociative symptoms are more likely to experience improved functioning and fewer residual symptoms. It is important for the psychiatrist to accurately diagnose depersonalization/derealization disorder, but also take the symptoms into account within the context of the trauma history when formulating a treatment plan. 4 Dissociation becomes pathological when the individual is unable to control when and where it occurs or when the adaptive measure becomes generalized to other situations and circumstances, or when it persists beyond the presence of danger. 1 Complicating factors include misdiagnosis and under-diagnosis, which may occur due to clinicians’ unfamiliarity with this spectrum of disorders, disbelief that they exist, 1, 3 or lack of knowledge and appreciation of the epidemiology of these disorders, particularly trauma history.ĭissociation often begins in childhood and can occur in adult life as a normal adaptive measure when danger or trauma is encountered the dissociated state presumably enables the individual to tolerate the circumstances. Dissociative disorders, along with other complex posttraumatic disorders with which they are often grouped, are very costly to individuals as well as the mental health delivery system. More recent research indicates the symptoms of these conditions are severe and disabling, resulting in high utilization of community resources including psychiatric services. The clinical vignettes focus on recommended psychotherapy and pharmacotherapy interventions as part of a comprehensive multidisciplinary treatment plan for these individuals.ĭissociative disorders were described prior to 1900 1, 2 but many years passed with little interest in this spectrum of psychiatric symptoms. ![]() This paper reviews clinical, phenomenological and epidemiological information regarding diagnosis and treatment of dissociative disorders in general, and illustrates common presenting histories of persons with derealization/depersonalization disorder utilizing composite cases. There are limited scientific data on prevalence of depersonalization/derealization disorder specifically. Although these disorders may be under-diagnosed or misdiagnosed, many persons with psychiatric illness who have experienced trauma report symptoms consistent with dissociative disorders. ![]() Depersonalization/derealization is categorized as one of the dissociative disorders, which also includes dissociative amnesia, dissociative fugue, dissociative identity disorder, and forms of dissociative disorder not otherwise specified. ![]() Depersonalization/derealization disorder is characterized by depersonalization often co-occurring with derealization in the absence of significant psychosis, memory, or identity disturbance.
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