Feeling unreal

30 cases of DSM-III-R depersonalization disorder

Daphne Simeon, Shira Gross, Orna Guralnik, Dan J. Stein, James Schmeidler, Eric Hollander

Research output: Contribution to journalArticle

105 Citations (Scopus)

Abstract

Objective: In contrast to the recent surge of interest in other dissociative disorders, DSM-III-R depersonalization disorder has not been thoroughly investigated and characterized. The authors systematically elucidated its phenomenology, comorbidity, traumatic antecedents, and treatment history. Method: Thirty adult subjects (19 women and 11 men) were consecutively recruited and administered various structured and semistructured interviews as well as the self-rated Dissociative Experiences Scale. An age- and sex-matched normal comparison group was also recruited. Results: The mean age at onset of depersonalization disorder was 16.1 years (SD=5.2). The illness had a chronic course that was usually continuous but sometimes episodic. Severe distress and high levels of interpersonal impairment were characteristic. Unipolar mood and anxiety disorders were common, but none emerged as specifically related to the depersonalization. A wide variety of personality disorders was manifested; avoidant, borderline, and obsessive-compulsive were most common. Although not highly traumatized, the subjects with depersonalization disorder reported significantly more childhood trauma than the normal comparison subjects. Depersonalization had been typically treatment refractory; only serotonin reuptake inhibitors and, to a lesser extent, benzodiazepines had been of any therapeutic benefit. Conclusions: This study supports the conceptualization of depersonalization disorder as a distinct disorder with a characteristic course that is independent of mood, anxiety, and personality symptoms. A subtle relationship may exist between childhood trauma and depersonalization disorder that merits further investigation. The disorder appears to be highly treatment refractory, and prospective treatment trials are warranted.

Original languageEnglish (US)
Pages (from-to)1107-1113
Number of pages7
JournalAmerican Journal of Psychiatry
Volume154
Issue number8
StatePublished - Aug 1997
Externally publishedYes

Fingerprint

Depersonalization
Diagnostic and Statistical Manual of Mental Disorders
Emotions
Dissociative Disorders
Therapeutics
Personality Disorders
Wounds and Injuries
Serotonin Uptake Inhibitors
Anxiety Disorders
Mood Disorders
Benzodiazepines
Age of Onset
Personality
Comorbidity
Anxiety
History
Interviews

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Simeon, D., Gross, S., Guralnik, O., Stein, D. J., Schmeidler, J., & Hollander, E. (1997). Feeling unreal: 30 cases of DSM-III-R depersonalization disorder. American Journal of Psychiatry, 154(8), 1107-1113.

Feeling unreal : 30 cases of DSM-III-R depersonalization disorder. / Simeon, Daphne; Gross, Shira; Guralnik, Orna; Stein, Dan J.; Schmeidler, James; Hollander, Eric.

In: American Journal of Psychiatry, Vol. 154, No. 8, 08.1997, p. 1107-1113.

Research output: Contribution to journalArticle

Simeon, D, Gross, S, Guralnik, O, Stein, DJ, Schmeidler, J & Hollander, E 1997, 'Feeling unreal: 30 cases of DSM-III-R depersonalization disorder', American Journal of Psychiatry, vol. 154, no. 8, pp. 1107-1113.
Simeon D, Gross S, Guralnik O, Stein DJ, Schmeidler J, Hollander E. Feeling unreal: 30 cases of DSM-III-R depersonalization disorder. American Journal of Psychiatry. 1997 Aug;154(8):1107-1113.
Simeon, Daphne ; Gross, Shira ; Guralnik, Orna ; Stein, Dan J. ; Schmeidler, James ; Hollander, Eric. / Feeling unreal : 30 cases of DSM-III-R depersonalization disorder. In: American Journal of Psychiatry. 1997 ; Vol. 154, No. 8. pp. 1107-1113.
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