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 author investigated neurotic symptoms of borderline patients by reviewing the clinical charts of twenty-six patients of longer than one year treatment period (8 men, 18 women; 23 patients with DSM III-R borderline personality disorder (BPD), 14 with schizotypal personality disorder (SPD), (11 BPD-SPD overlaps); age at the first contact: mean = 24.3 y. o., SD = 6.7 y. o.; treatment period: mean = 51 months, SD = 35 months). The diagnoses of the comorbid neurotic disorders were obsessive compulsive disorder: 5 cases (19% (BPD: 22%, SPD: 7%)), somatoform disorder: 5 (19% (BPD: 22%, SPD: 21%)), panic disorder: 4 (15% (BPD: 17%, SPD: 14%)), social phobia: 2 (8% (BPD: 9%, SPD: 7%)), dissociative disorder: 2 (8% (BPD: 9%, SPD: 0%)), and generalized anxiety disorder: 1 (4% (BPD: 4%, SPD: 7%)). The neurotic symptoms identified in the charts of the subjects were as follows; symptoms of social phobia: 11 cases (42% (BPD: 43%, SPD: 43%)) including 6 with anthropophobic symptoms (23% (BPD: 26%, SPD: 36%)), obsessive compulsive symptoms and diffuse and floating anxiety: 9 (35% (BPD: 39%, SPD: 38%)), panic attacks: 8 (31% (BPD: 35%, SPD: 36%)), conversion symptoms: 7 (27% (BPD: 30%, SPD: 21%)), dissociative episodes: 6 (23% (BPD: 26%, SPD: 7%)), depersonalization: 5 (19% (BPD: 22%, SPD: 14%)), multiple apprehensive expectations: 4 (15% (BPD: 17%, SPD: 14%)), derealization: 3 (12% (BPD: 13%, SPD: 14%)), hyperventilation attacks: 3 (12% (BPD: 13%, SPD: 7%)), and somatization: 1 (4% (BPD: 4%, SPD: 7%)). In short, 54% (BPD: 61%, SPD: 43%) of the subjects had comorbid neurotic disorders, and 92% (BPD: 91%, SPD: 93%) reported at least one, and 54% (BPD: 61%, SPD: 50%), more than two kinds of neurotic symptoms, though no specific symptom correlating with BPD or SPD diagnosis was found. These findings suggest that neurotic symptoms and neurotic disorders cannot be ignored as peripheral in the borderline symptomatology. By analyzing in detail the neurotic experiences, the author pointed out as their characteristics, ego syntonicity, deterioration of reality sense and symptomatic polymorphism, ambiguity and multiplicity (panneurosis). In the symptoms the author observed signs of defective personality functioning such as disavowal of reality, low anxiety tolerance, various forms of identity disturbances. The findings counted above, suggest that the borderline neurotic symptoms are more severe in nature than those of neurotics, and could be situated in between neurotic and psychotic levels of symptomatic severity. The results indicate that the neurotic experiences of borderline patients are, as a whole, deeply ingrained in the borderline psychopathology.
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PMID:[Neurotic symptoms of borderline patients: a case review study]. 143 98

Depersonalization disorder is classified in DSM-III-R (APA 1987) as a dissociative disorder characterized by altered perception or experience of the self. To date, there are no known reports of the neurobiological features of this disorder. We report clinical and biological correlates in a patient with depersonalization disorder previously unresponsive to a variety of anticonvulsant, monoamine oxidase inhibitor, and tricyclic antidepressant trials, but for whom fluoxetine partially reduced depersonalization symptoms, but not associated anxiety and depression. Neurophysiological, neuroanatomical and neuropsychological findings revealed left hemispheric frontal-temporal activation and decreased left caudate perfusion. These findings suggest a similarity to the neuropsychiatric data reported in obsessive-compulsive disorder patients.
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PMID:Left hemispheric activation in depersonalization disorder: a case report. 152 79

The 28-item Dissociative Experiences Scale was administered to a stratified cluster sample of 1,055 respondents in the general population of Winnipeg. Dissociative experiences were common in the sample and were not related to socioeconomic status, sex, education, religion, or place of birth, although they declined with age in both sexes. A principal components analysis identified three factors accounting for 47.1 percent of the combined variance of the scores. The first factor, absorption-imaginative involvement, is composed of common, benign experiences, such as missing part of a conversation and being able to ignore pain. The other two factors, activities of dissociated states and depersonalization-derealization, composed of less common experiences such as not recognizing friends or family members and not recognizing one's reflection in a mirror, may be powerful predictors of DSM-III-R dissociative disorders.
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PMID:Dissociative experiences in the general population: a factor analysis. 203 14

The dexamethasone suppression test (DST), the thyrotropin releasing hormone (TRH) test, and the ratio of plasma L-tryptophan to competing amino acids (L-TRP/CAA) were studied in relation to the 21 items of the Hamilton Depression Rating Scale (HDRS) in 123 depressed patients categorized according to DSM-III. The relationships between the biological data and the items or item clusters of the HDRS were assessed by multivariate analyses. The psychopathological correlates of increased post-dexamethasone cortisol and decreased thyroid stimulating hormone (TSH) responsivity to TRH were middle and delayed insomnia and weight loss. The symptom correlates of decreased availability of L-TRP to the brain were psychic anxiety, depersonalization, obsessions and paranoid symptoms. Core depressive symptoms, i.e. depression, loss of interest, feelings of guilt and suicidal thoughts, were not related to the biological markers.
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PMID:Symptom profiles of biological markers in depression: a multivariate study. 211 48

The authors describe the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D), which investigates five groups of dissociative symptoms (amnesia, depersonalization, derealization, identity confusion, and identity alteration) and systematically rates both the severity of individual symptoms and the evaluation of overall diagnosis of dissociative disorder. Preliminary findings from a study of 48 subjects with and without psychiatric diagnoses indicate good to excellent reliability and discriminant validity for the SCID-D as a diagnostic instrument for the five dissociative disorders and as a tool for the evaluation of dissociative symptoms encountered within nondissociative syndromes.
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PMID:The Structured Clinical Interview for DSM-III-R Dissociative Disorders: preliminary report on a new diagnostic instrument. 240 15

Transient amnesias, fugues, twilight states, automatisms, depersonalization, and furors or explosive disorders can occur in association with, or be caused by, various medications or substance-induced organic brain states. Agents capable of precipitating dissociative-like states include alcohol, barbiturates and similarly acting hypnotics, benzodiazepines, scopolamine, clioquinol, beta-adrenergic blockers, marijuana and certain psychedelic drugs, general anesthetics, and others. The presentations of substance-induced dissociative states may resemble those of functional dissociative disorders, or organic and psychogenic dissociative factors may coexist and be intertwined or indistinguishable. Organic dissociative states are distinct from intoxication, amnestic disorder, frank delirium, or other organic mental disorders as specified in DSM-III and DSM-III-R, yet these diagnostic manuals have no inclusive category or coherent nosological approach to dissociative states not strictly psychogenic in etiology. Substance-induced and other organic dissociative disorders can have clinical, medicolegal, and neuropsychological significance. They provide a unique opportunity for the study of mind-brain relationships and should be included in psychiatric nosology.
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PMID:Substance-induced dissociative disorders and psychiatric nosology. 265 80

This paper reviews anxiety, panic, and phobic disorders as they were described in landmark works, along with more recent epidemiologic studies of the disorders. The author discusses clinical syndromes of anxiety as outlined in the DSM-III: agoraphobia, social phobia, generalized anxiety disorder, panic disorder, simple phobic states, and obsessive-compulsive disorder, relating them to Phobic Anxiety-Depersonalization Syndrome and to earlier descriptions by Westphal and Benedict. The paper addresses the problem of delineating anxiety and phobic states from depressive disorders, with regard to diagnosis and treatment outcome. Various etiological bases of agoraphobia, panic, and anxiety disorders are suggested: heredity, life events and circumstances, family background and developmental history, the premorbid personality, and some psychological aspects. Several questions are explored on the relationships of agoraphobia, anxiety and panic attacks. For example, is agoraphobia a new disease or one stage in the development of severe chronic anxiety? Are the phobias of agoraphobia acquired by conditioning or learning? Are "panics" spontaneous or physiological? Are panic attacks the first event in the primary cause of agoraphobia? For future work the authors propose a reassessment of the prevalence of agoraphobia and related disorders, a more careful definition of the agoraphobic disorders, and thorough clinical investigation of the various treatment modalities in well-defined populations. The past twenty years' achievements in behavioural and pharmacological treatments for agoraphobia are briefly recapitulated.
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PMID:Anxiety, panic and phobic disorders: an overview. 305 59

Schizotypal and borderline personality disorders (SPD and BPD, respectively) appear to be different at follow-up, yet they are poorly discriminated from each other by current DSM-III symptom criteria. In the Chestnut Lodge Follow-up Study, three axis II study cohorts (pure SPD, n = 10; pure BPD, n = 81; mixed SPD/BPD, n = 18) with distinctive outcomes are defined using current borderline systems. This study compares the relative frequency with which individual symptom criteria from each system discriminate across study cohorts. Findings suggest that for SPD, the most characteristic (core) DSM-III symptoms are odd communication, suspiciousness/paranoid ideation, and social isolation, while the least discriminating symptom is illusions/depersonalization/derealization; the core DSM-III symptoms for BPD are unstable relationships, impulsivity, and self-damaging acts, while the least discriminating symptoms are inappropriate anger and intolerance of aloneness; depression as a symptom does not discriminate between SPD and BPD; and transient psychoses and brief paranoid experiences and/or regression in treatment discriminate for SPD but against BPD and therefore fit better as SPD criteria. Results support the retention of some, but the elimination of other, DSM-III symptom criteria for the diagnosis of SPD and BPD.
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PMID:Testing DSM-III symptom criteria for schizotypal and borderline personality disorders. 381 9

Do patients with borderline personality disorder (BPD) display psychotic symptoms as part of their syndrome? This question has important theoretical significance, since it bears on the question of whether BPD lies 'on the border' of psychotic functioning, or whether it is unrelated to psychotic disorders. A review of available evidence suggests that 'narrowly defined' psychotic symptoms, such as those included under the DSM-III definition of psychosis, are rare in BPD. Furthermore, when such symptoms have been reported in BPD, they may have been attributable to a concomitant, possibly independent, disorder suffered by the patient, such as substance abuse or major affective disorder. Broadly defined psychotic symptoms, such as depersonalization, are much more often reported in BPD, but many of these symptoms have also been reported frequently in patients with non-psychotic disorders and in normals. Finally, the prevalence of factitious psychotic symptoms in BPD has not been systematically investigated. Thus, the evidence for psychotic symptoms in BPD remains equivocal.
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PMID:Psychosis in borderline personality disorder. 639 40

Agoraphobia, now a clinically accepted entity (DSM-III) was first described more than 100 years ago in the psychiatric literature. Recently, it has been considered a syndrome, with phobia, anxiety and depersonalization being the prominent symptoms. Its etiology is not clear and different schools of thought have given different explanations for its causation. Few reports of recent origin have have described a close association between the intake and/or discontinuation of pharmacologic agents and the onset of the syndrome. The agents implicated were the tricyclic group. Our report describes another "antidepressant," d-amphetamine, which when discontinued by our patient, was followed by the full syndrome of agoraphobia.
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PMID:Agoraphobia following amphetamine withdrawal. 708 80


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