Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011551 (depersonalization)
 1,117 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 34-year-old woman with a 9-year history of unprovoked attacks of anxiety and dyspnea associated with symptoms of depersonalization and derealization is presented. The attacks increased in frequency and were associated with internal derogatory voices, vivid frightening imagery, and suicidal ideation, leading to 3 emergency psychiatric hospitalizations in a period of less than 3 months. She had been treated unsuccessfully for a presumptive diagnosis of panic disorder without agoraphobia, prompting a reconsideration of this diagnosis. Although electroencephalography and magnetic resonance imaging findings were normal, temporal lobe epilepsy was considered and the patient responded rapidly and dramatically to carbamazepine. Panic disorder and temporal lobe epilepsy can be confused with each other; proper diagnosis is necessary for selection of effective pharmacotherapy. Although uncertain, the contribution of sustained exposure to carbon monoxide as an adult may have contributed to the emergence of panic symptoms, which would be an unusual clinical presentation.
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PMID:Temporal lobe epilepsy confused with panic disorder: implications for treatment. 1948 84

Various empirical data suggest that individuals with Panic Disorder (PD) fail to appropriately assign significance to sensory stimuli within the internal and external milieu, including those stimuli which are patently threat-neutral. The failure to appropriately discriminate 'signal' stimuli from among 'noise' signals [Gordon, E., Liddell, B.J., Brown, K.J., Bryant, R., Clark, C.R., Das, P., et al. 2007. Integrating objective gene-brain-behavior markers of psychiatric disorders. J. Integr. Neurosci. 6, 1-34.] results in disturbances of information processing and attentional deployment, which manifests across multiple levels of functioning (e.g., brain, behaviour, autonomic). The present event-related potential (ERP) study, therefore, investigated attentive information processing in PD, using a standard two-tone auditory oddball paradigm, to assess patients' response to infrequent 'target' tones (i.e., signals) and frequent 'non-target' tones (i.e., noise). Simultaneously-recorded autonomic data provided converging measures of the concomitants of disordered information processing. PD patients (n=50) showed increased N1 amplitude to frequent non-target tones and reduced P3 amplitude to infrequent targets, compared to matched controls (n=98). There were no between-group differences for N1 targets, N2 or P2. Patients additionally showed increased heart rate, fewer spontaneous skin conductance responses (trend) to significant stimuli, and reduced P3 latency compared to controls, although the latter result was accounted for by patients who frequently experienced depersonalization and/or derealisation during panic. Patients showed several disturbances of attentive information processing in a simple auditory discrimination task: Increased N1 to repeated stimuli suggests impaired stimulus filtering, whereas reduced P3 amplitude and latency represent the under-allocation of neural resources for infrequent, goal-relevant stimuli, and their increased speed of processing, respectively. These disturbances likely contribute to patients' aversive outcomes in stimulus-rich environments.
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PMID:Event-related potential and autonomic signs of maladaptive information processing during an auditory oddball task in panic disorder. 1960 64

Eye Closure, Eye Movements (ECEM) is a hypnotically-based approach to treatment that incorporates eye movements adapted from the Eye Movement Desensitization and Reprocessing (EMDR) protocol in conjunction with hypnosis for the treatment of depersonalization disorder. Depersonalization Disorder has been differentiated from post-traumatic stress disorders and has recently been conceptualized as a subtype of panic disorder (Baker et al., 2003; David, Phillips, Medford, & Sierra, 2004; Segui et. al., 2000). During ECEM, while remaining in a hypnotic state, clients self-generated six to seven trials of eye movements to reduce anticipatory anxiety associated with depersonalization disorder. Eye movements were also used to process triggers that elicited breath holding, often followed by episodes of depersonalization. Hypnotic suggestions were used to reverse core symptoms of depersonalization, subjectively described as "feeling unreal" (Simeon et al., 1997).
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PMID:ECEM (Eye Closure, Eye Movements): application to depersonalization disorder. 1986 96

Dissociative symptoms including depersonalization and derealization are commonly experienced by individuals suffering from panic disorder or posttraumatic stress disorder (PTSD). Few studies have been published investigating the specific treatment of these symptoms in individuals diagnosed with panic disorder or PTSD, despite evidence that the subset of individuals with panic disorder who experience depersonalization and derealization report more panic attacks as well as greater panic severity and functional impairment. Furthermore, it has been shown that these symptoms can impede treatment and recovery in PTSD. Finally, recent research has shown that interoceptive exposure generally enhances the efficacy of treatment outcome for PTSD and PTSD with comorbid panic. This study investigated the use of a novel interoceptive exposure technique for treatment of depersonalization and derealization in individuals with high anxiety sensitivity and/or symptoms of PTSD. Results indicated significant reductions on six of seven items as well as total score on an outcome measure of depersonalization and derealization. Thus, this technique appears to hold promise for utilization as a form of interoceptive exposure in the treatment of these symptoms.
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PMID:A preliminary evaluation of repeated exposure for depersonalization and derealization. 2311 74

This study assessed childhood trauma history, dissociative symptoms, and dissociative disorder comorbidity in patients with panic disorder (PD). A total of 92 psychotropic drug-naive patients with PD, recruited from outpatient clinics in the psychiatry department of a Turkish hospital, were involved in the study. Participants were assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), Dissociation Questionnaire, Panic and Agoraphobia Scale, Panic Disorder Severity Scale, and Childhood Trauma Questionnaire. Of the patients with PD, 18 (19%) had a comorbid dissociative disorder diagnosis on screening with the SCID-D. The most prevalent disorders were dissociative disorder not otherwise specified, dissociative amnesia, and depersonalization disorders. Patients with a high degree of dissociation symptoms and dissociative disorder comorbidity had more severe PD than those without (p < .05). All of the childhood trauma subscales used were correlated with the severity of symptoms of dissociation and PD. Among all of the subscales, the strongest relationship was with childhood emotional abuse. Logistic regression analysis showed that emotional abuse and severity of PD were independently associated with dissociative disorder. In our study, a significant proportion of the patients with PD had concurrent diagnoses of dissociative disorder. We conclude that the predominance of PD symptoms at admission should not lead the clinician to overlook the underlying dissociative process and associated traumatic experiences among these patients.
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PMID:Childhood Traumatic Experiences, Dissociative Symptoms, and Dissociative Disorder Comorbidity Among Patients With Panic Disorder: A Preliminary Study. 2601 85

The self-disorder model offers a unifying way of conceptualizing schizophrenia's highly diverse symptoms (positive, negative, disorganized), of capturing their distinctive bizarreness, and of conceiving their longitudinal development. These symptoms are viewed as differing manifestations of an underlying disorder of ipseity or core-self: hyper-reflexivity/diminished-self-presence with accompanying disturbances of "grip" or "hold" on reality. Recent revision to this phenomenological theory, in particular distinguishing primary-vs-secondary factors, offers a bio-pheno-social model that is consistent with recent empirical findings and offers several advantages: (1) It helps account for the temporal variations of the symptoms or syndrome, including longitudinal progression, but also the shorter-term, situationally reactive, and sometimes defensive or quasi-intentional variability of symptom-expression that can occur in schizophrenia (consistent with understanding some aspects of ipseity-disturbance as dynamic and mutable, involving shifting attitudes or experiential orientations). (2) It accommodates the overlapping of some key schizophrenic symptoms with certain nonschizophrenic conditions involving dissociation (depersonalization, derealization), including depersonalization disorder and panic disorder, thereby acknowledging both shared and distinguishing symptoms. (3) It integrates recent neurocognitive and neurobiological as well as psychosocial (eg, influence of trauma and culture) findings into a coherent but multi-factorial neuropsychological account. An adequate model of schizophrenia will postulate shared disturbances of core-self experiences that nevertheless can follow several distinct pathways and occur in various forms. Such a model is preferable to uni-dimensional alternatives-whether of schizophrenia or ipseity-disturbance-given its ability to account for distinctive yet varying experiential and neurocognitive abnormalities found in research on schizophrenia, and to integrate these with recent psychosocial and neurobiological findings.
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PMID:Varieties of Self Disorder: A Bio-Pheno-Social Model of Schizophrenia. 2952 66

There is increasing evidence and recognition that Lyme borreliosis (LB) causes mental symptoms. This article draws from databases, search engines and clinical experience to review current information on LB. LB causes immune and metabolic effects that result in a gradually developing spectrum of neuropsychiatric symptoms, usually presenting with significant comorbidity which may include developmental disorders, autism spectrum disorders, schizoaffective disorders, bipolar disorder, depression, anxiety disorders (panic disorder, social anxiety disorder, generalized anxiety disorder, posttraumatic stress disorder, intrusive symptoms), eating disorders, decreased libido, sleep disorders, addiction, opioid addiction, cognitive impairments, dementia, seizure disorders, suicide, violence, anhedonia, depersonalization, dissociative episodes, derealization and other impairments. Screening assessment followed by a thorough history, comprehensive psychiatric clinical exam, review of systems, mental status exam, neurological exam and physical exam relevant to the patient's complaints and findings with clinical judgment, pattern recognition and knowledgeable interpretation of laboratory findings facilitates diagnosis. Psychotropics and antibiotics may help improve functioning and prevent further disease progression. Awareness of the association between LB and neuropsychiatric impairments and studies of their prevalence in neuropsychiatric conditions can improve understanding of the causes of mental illness and violence and result in more effective prevention, diagnosis and treatment.
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PMID:Neuropsychiatric Lyme Borreliosis: An Overview with a Focus on a Specialty Psychiatrist's Clinical Practice. 3014 26

Although several treatment options for panic disorder (PD) are available, the best intervention for each individual patient remains uncertain and the use of a more personalized therapeutic approach in PD is required. In clinical practice, clinicians combine general scientific information and personal experience in the decision-making process to choose a tailored treatment for each patient. In this sense, clinicians already use a somehow personalized medicine strategy. However, the influence of their interpretative personal models may lead to bias related to personal convictions, not sufficiently grounded on scientific evidence. Hence, an effort to give some advice based on the science of personalized medicine could have positive effects on clinicians' decisions. Based on a narrative review of meta-analyses, systematic reviews, and experimental studies, we proposed a first-step attempt of evidence-based personalized therapy for PD. We focused on some phenomenological profiles, encompassing symptoms during/outside panic attacks, related patterns of physiological functions, and some aspects of physical health, which might be worth considering when developing treatment plans for patients with PD. We considered respiratory, cardiac, vestibular, and derealization/depersonalization profiles, with related implications for treatment. Given the extensiveness of the topic, we considered only medications and some somatic interventions. Our proposal should be considered neither exhaustive nor conclusive, as it is meant as a very preliminary step toward a future, robust evidence-based personalized therapy for PD. Clearly much more work is needed to achieve this goal, and recent technological advances, such as wearable devices, big data platforms, and the application of machine learning techniques, may help obtain reliable findings. We believe that combining the efforts of different research groups in this work in progress can lead to largely shared conclusions in the near future.
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PMID:Toward a personalized therapy for panic disorder: preliminary considerations from a work in progress. 3137 69

Derealization and depersonalization and are commonly experienced by individuals with panic disorder. Although interoceptive exposure (IE) is a key therapeutic component in the treatment of panic disorder, there currently are few recognized ways to elicit reactions that successfully mimic dissociative symptoms commonly experienced during panic. We examined the ability of several novel methods that elicit anomalous and confusing perceptual experiences to induce at least moderately intense dissociative reactions in a college student sample (N = 34). Two of the novel procedures (i.e., stripes and hand) and a task previously identified as effectively eliciting dissociative symptoms, strobe light plus three-dimensional (3D) glasses reliably induced derealization/depersonalization reactions. The implications of these findings for further research and the clinical practice of IE in treatment of panic attacks are discussed.
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PMID:The Development of Novel Interoceptive Exposure Methods for Inducing Derealization and Depersonalization Symptoms. 3275 26


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