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)

The study of clinical-psychopathological characteristics of initial stages of schizotypal disorder was carried out on a sample of 54 male inpatients. Based on the results of clinical-psychopathological and follow-up studies, authors found that symptoms of initial stages of schizotypal disorder presented by non-psychotic depressive disorders. Dissociation of depressive symptoms, heterogeneity and unsteadiness of leading affect, marked polymorphism of depressive presentations, presence of concomitant neurotic-like and psychopathic-like disorders are characteristic of these depressive disorders. Five clinical variants of states described in the initial stages of disease are singled out: depression with symptom- complex of asthenic incompetence (25.9%), apathic-adynamic depression (27.7%), anxiety-depressive (16.6%), depersonalization-depressive (20.4%) states, hypochondriac depressions (9.3%).
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PMID:[Clinical characteristics of initial stages of schizotypal disorder]. 2281 Jul 36

An increasing amount of empirical studies demonstrates that anomalies of self-experience (self-disorders) are characteristic of schizophrenia and related spectrum conditions, indicating that self-disorders (SDs) are likely to constitute important vulnerability phenotypes. On a clinical level, SDs are non-psychotic alterations of subjective experience that include disturbances of self-awareness (e.g., fading first-person perspective, waning sense of basic identity, depersonalization and hyperreflectivity), autopsychic disorders (e.g., thought pressure or block, perceptualization of mental stream and spatialization of thoughts), loss of common sense (e.g., perplexity), and existential alterations (e.g., solipsistic grandiosity). Such experiences, define essential aspects of the clinical expressions of schizophrenia lending psychopathological coherence to its spectrum manifestations. Furthermore the experiential nature of SDs makes them amenable to the patient's introspection which can be elicited in the dialogical context of the psychiatric interview with important implication for the therapeutic relation. The aim of this presentation is to illustrate the phenomenological core of these experiential anomalies, emphasizing their topicality for the exploration of vulnerability to schizophrenia spectrum conditions and their coherence with the overall clinical picture.
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PMID:Self-disorders and the experiential core of schizophrenia spectrum vulnerability. 2311 7

OBJECTIVE The authors examined the development of psychotic experiences and psychotic disorders in a large population-based sample of young adults and explored their relationship to psychotic phenomena earlier in childhood. METHOD The authors conducted a longitudinal birth cohort study of individuals assessed with the semistructured Psychosis-Like Symptom Interviews at ages 12 and 18 years. RESULTS Of the 4,724 individuals interviewed at age 18, 433 (9.2%) had either suspected (N=203 [4.3%]) or definite (N=230 [4.9%]) psychotic experiences. Of these, 79 (1.7%) met criteria for a psychotic disorder, and of those, only 50% sought professional help. All psychotic outcomes were more likely in young women and in those from socioeconomically disadvantaged backgrounds. Of the participants who had psychotic experiences at age 12, 78.7% had remitted by age 18. The risk of psychotic disorders at age 18 was greater in those with suspected (odds ratio=5.6, 95% CI=2.6-12.1) and especially in those with definite (odds ratio=12.7, 95% CI=6.2-26.1) psychotic experiences at age 12, and also among those with psychotic experiences at age 12 attributed to sleep or fever or with nonpsychotic experiences such as depersonalization. The positive predictive values for increasing frequency of experiences at age 12 predicting psychotic disorders at age 18 ranged from 5.5% to 22.8%. CONCLUSIONS Despite evidence for a continuum of psychotic experiences from as early as age 12, positive predictive values for predicting psychotic disorders were too low to offer real potential for targeted interventions. Psychotic disorders in young adults are relatively uncommon, but they constitute an important unmet need for care given that half of the individuals in this study who met criteria for a psychiatric disorder had not sought help for these problems despite high levels of associated distress and impairment.
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PMID:Psychotic experiences and psychotic disorders at age 18 in relation to psychotic experiences at age 12 in a longitudinal population-based cohort study. 2382 Aug 27

The aim of this review is to describe the potential relationship between multisensory disintegration and self-disorders in schizophrenia spectrum disorders. Sensory processing impairments affecting multisensory integration have been demonstrated in schizophrenia. From a developmental perspective multisensory integration is considered to be crucial for normal self-experience. An impairment of multisensory integration is called 'perceptual incoherence'. We theorize that perceptual incoherence may evoke incoherent self-experiences including depersonalization, ambivalence, diminished sense of agency, and 'loosening of associations' between thoughts, feelings and actions that lie within the framework of 'self-disorders' as described by Sass and Parnas (2003). We postulate that subconscious attempts to restore perceptual coherence may induce hallucinations and delusions. Increased insight into mechanisms underlying 'self-disorders' may enhance our understanding of schizophrenia, improve recognition of early psychosis, and extend the range of therapeutic possibilities.
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PMID:Schizophrenia as a self-disorder due to perceptual incoherence. 2397 19

Several lines of scientific evidence showed that topiramate may induce psychotic symptoms when used as monotherapy. It has been postulated that this topiramate effect may be caused by the inhibition of frontal and prefrontal areas induced by topiramate. The clinical history of the patient described shows that topiramate may also induce psychosis when used in polytherapy. A 34-year-old man, with epilepsy associated to tuberous sclerosis complex and without a previous history of mental disorders, presented an acute onset of florid psychotic symptoms, including visual and auditory hallucinations, derealization, and depersonalization. These symptoms appeared 1 month after the introduction of topiramate, added to levetiracetam and carbamazepine, when topiramate reached the dose of 200 mg daily. Once topiramate was discontinued, the psychotic symptoms disappeared, with no recurrence in a 4-month follow-up. Psychotic symptoms were associated with topiramate administration. We hypothesized that psychotic symptoms appeared a month after the topiramate introduction because of the slow topiramate titration and protective effect of carbamazepine.
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PMID:Timing and clinical characteristics of topiramate-induced psychosis in a patient with epilepsy and tuberous sclerosis. 2443 33

A high variety of factors were found to be implicated in the emergence of depersonalization episodes. The remarkable case of a patient who developed a hemi-depersonalization syndrome is reported in a patient with known obsessive-compulsive disorder. He complained of feeling his left half of the body as if it was detached from him. The part of the body that was perceived as estranged was inconsistent with the anatomical distribution of the nervous system as the entire left part of his body was concerned, from head to toe. He always remained aware that the sensations were not real, and felt like being an outside observer of the left side of his body. He also developed an isolated delusional idea. The hemi-depersonalization syndrome as well as the delusional idea did not respond to citalopram 20 mg/day, but remitted rapidly under olanzapine 10 mg/day, the obsessive-compulsive symptomatology persisting for several weeks. From the course of hemi-depersonalization syndrome and the available literature, it is concluded that this syndrome is independent from the concomitant OCD and that the observed hemi-depersonalization syndrome is likely to be a manifestation of a psychotic reaction which consisted of both the hemi-depersonalization and delusions.
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PMID:Hemi-depersonalization syndrome. 2494 42

Substance abuse among medical professionals is a cause for concern. Certain psychotropic substances such as ketamine are at easy dispense to anesthesiologists increasing the likelihood of misuse and dependence and raise several issues including safety of patients. We discuss a case demonstrating ketamine dependence in an anesthesiologist from India. The reported psychotropic effects of ketamine ranged from dissociation and depersonalization to psychotic experiences. There was also development of significant tolerance to ketamine without prominent physical withdrawal symptoms and cyclical use of very high doses was observed. Issues related to management of health professionals are also discussed.
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PMID:Ketamine dependence in an anesthesiologist: an occupational hazard? 2503 66

The Prodromal Questionnaire (PQ) identifies psychiatric help-seekers in need of clinical interviews to diagnose psychosis risk. However, some providers use the PQ alone to identify risk. Therefore, we tested its predictive utility among 731 adolescent psychiatric help-seekers, with a 3-9-year register-based follow-up. Nine latent factors corresponded well with postulated subscales. Depersonalization predicted later hospitalization with a psychosis diagnosis (HR 1.6 per SD increase), and Role Functioning predicted any psychiatric hospitalization (HR 1.3). Published cut-off scores were poor predictors of psychosis; endorsement rates were very high for most symptoms. Therefore, we do not recommend using the PQ without second-stage clinical interviews.
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PMID:Predicting psychosis and psychiatric hospital care among adolescent psychiatric patients with the Prodromal Questionnaire. 2506 72

Delusions are, in part, attempts to explain confusing anomalous experience. Depersonalization, a key subset of anomalous experience, has been little studied in relation to persecutory delusions. The aims of this study were to assess the presence of depersonalization in patients with persecutory delusions and to examine associations with levels of paranoia and worry. Fifty patients with a current persecutory delusion completed measures of depersonalization, psychotic symptoms, and worry. Depersonalization experiences were common: 30 patients (60%) each reported at least 10 different depersonalization symptoms occurring often. A greater number of depersonalization experiences were associated with higher levels of paranoia and worry. The positive association of worry and paranoia became nonsignificant when controlling for depersonalization. Overall, depersonalization may be common in patients with persecutory delusions and is associated with the severity of paranoia. The results are consistent with the view that worry may cause depersonalization experiences that contribute to the occurrence of paranoid thoughts.
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PMID:Depersonalization in patients with persecutory delusions. 2519 1

Transition to psychosis in at-risk individuals has markedly declined in recent years. So far it has never been discussed in detail that with the growing awareness and increasing availability of early psychosis services, a much broader diagnostic spectrum is now being seen in these services. Subsequently, subjects present with symptoms that meet psychosis risk on a purely psychometric basis but may be the phenotypical expression of another underlying mental disorder. Here we critically review four groups of symptoms and clinical features that are frequently reported by individuals with suspected psychosis risk states, yet share strong commonalities with other mental disorders and conditions: isolated hallucinations; unusual bodily perceptions, hypochondriatic fears and cenesthetic psychotic symptoms; depersonalization; obsessive-compulsive, overvalued and delusional ideas. Of the 616 individuals so far assessed in the Bruderholz Early Psychosis Outpatient Service for Adolescents and Young Adults, 218 (30.5%) met ultra-high risk (UHR) criteria, 188 (86.2%) of whom suffered from one of the four above-mentioned symptom groups. The appraisal of the diagnostic spectra and their overlapping symptoms constitute a tremendous challenge in the clinical assessment of each referred individual. The final conclusion of a clinical assessment should not end with the mere assignment - or non-assignment - to a presumed psychosis risk group, but needs to take into account the 'Gestalt' of these particular symptoms and clinical features and thus be based on many more facets than solely a psychometric or nosological approach. Such an approach may break down the heterogeneous psychosis risk group and enable appropriate treatment regimes.
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PMID:Declining transition rates to psychosis: the role of diagnostic spectra and symptom overlaps in individuals with attenuated psychosis syndrome. 2526 94


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