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Query: UMLS:C0011551 (depersonalization)
 1,117 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The test-retest reliability of the Dissociative Experiences Scale (DES; Bernstein EM, Putnam FW [1986] Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease 174:727-735) in a clinical sample was found to be .93 for the total DES score and .95, .89, and .82 for the three subscale scores of amnesia, depersonalization-derealization, and absorption (dissociative identity disorder [DID], DSM-IV), respectively. Test-retest reliabilities within diagnostic groups of multiple personality disorder, dissociative disorder not otherwise specified, and a general other category of psychiatric diagnoses were obtained for total and subscale scores on the DES. These ranged from .78 to .96. Tests of mean scores across the two test sessions showed the total and subscale scores to be temporally stable. The DES was also found to be highly internally consistent: Cronbach's alphas of .96 and .97 were observed for the total DES scores taken at times 1 and 2, respectively. Construct validity of the DES was demonstrated by differentiation among the subscale scores in a repeated-measures analysis of variance (F[2,154] = 32.03, p < or = .001). Normality and general distribution issues were also addressed and provided a rationale for using the DES with parametric statistics. Reasons why the DES (as it was originally designed) is not appropriate as a dependent measure in outcome research are discussed, along with needed future research. Implications of the findings for the clinical usefulness of the DES as a diagnostic instrument are noted.
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PMID:Psychometric properties of the Dissociative Experiences Scale. 771 11

Description of psychasthenia by P. Janet (1903) sets up at the end of a double reflection, with on the one hand a theorization of asthenia, the notion of which already occupied the medical concepts of the 18th and 19th centuries, and on the other hand a progressive attribution of neurosis to the psychiatric field. Its clinical characteristics (feelings of non-fulfillment in action and emotion, experiences of oddness and depersonalization, obsessions, phobias...) makes psychasthenia a fully-fledged illness, the psychopathological organization of which results from a decrease of psychological tension and from a loss of reality function. Since P. Janet, the term of psychasthenia has not ceased to be used, although its etiopathological references blurred behind the psychoanalytic work, and it is usually synonymous with obsessional neurosis, even with obsessional personality. Description of psychasthenia appears in these rubrics of the DSM III, even though the term itself is ignored.
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PMID:[Psychasthenia: history and evolution of the P. Janet concept]. 784 50

Using the criteria of the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D), we assessed the incidence of feelings of unreality among a sample of 70 persons who had sustained head injuries. Among those whose head trauma could be classified as mild, more than 60% complained of a depersonalization syndrome. Among those with a significant period of unconsciousness, only 11% had similar complaints. There was a high comorbidity with post-traumatic stress disorder and vertigo. Feelings of unreality were not associated with cognitive impairment or elevated personality test scores, nor were there significant relationships with gender or involvement in litigation. A conservative estimate of incidence of depersonalization among persons with minor head trauma is 13%, while, at the upper end, as many as 67% of persons who sustain mild head injury may experience feelings of unreality.
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PMID:Incidence and correlates of depersonalization following head trauma. 826 Sep 54

The stress associated with experiencing or witnessing physical trauma can cause abrupt and marked alterations in mental state, including anxiety and transient dissociative symptoms. Intense manifestations of this pattern of response to trauma are described in a new diagnostic category proposed for DSM-IV: acute stress disorder. Severe dissociative symptoms may predict subsequent posttraumatic stress disorder. Persons who experience a series of traumatic events may be especially vulnerable to a variety of dissociative states, including amnesia, fugue, depersonalization, and multiple personality disorder. Treatment for these symptoms emphasizes strengthening supportive interpersonal relationships and developing insight that reduces psychological pain by integrating the trauma into a meaningful, less self-blaming perspective.
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PMID:Trauma and dissociation. 850 55

The primary aim of the present study was to investigate the association between spontaneous experiences of depersonalization or derealization (D-D) during panic states and hypnosis in low and highly hypnotizable phobic individuals. Secondarily, the association among level of hypnotizability, capacity for imaginative involvement, and severity of phobic complaints was also assessed. Sixty-four patients with panic disorder with agoraphobia according to the DSM-III-R (American Psychiatric Association, 1987) criteria participated in the study. Proneness to experience D-D during hypnosis was positively related to hypnotizability, but only for agoraphobic patients who had already experienced these perceptual distortions during panic episodes. Correlations of level of hypnotizability and capacity for imaginative involvement with severity of agoraphobic complaints were not significant. These findings suggest that hypnotizability may be a mediating variable between two different, although phenotypically similar, perceptual distortions experienced during panic states and hypnosis. Implications for both theory and clinical practice are discussed.
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PMID:Depersonalization and derealization during panic and hypnosis in low and highly hypnotizable agoraphobics. 899 Dec 95

In a sample of 131 patients with panic disorder, we explored both the presence of DSM-III-R criteria for hypochondriasis and the occurrence of illness phobia before the onset of panic disorder. To explore further the possible relationship between hypochondriacal features and panic-agoraphobic syndrome, we compared patients both with and without current hypochondriasis and then patients both with and without illness phobia before the onset of panic disorder. Finally, we investigated the relationship between premorbid phobic-anxious traits and hypochondriasis during panic disorder. No differences were found between patients with and without hypochondriasis, either in terms of clinical features or in the course of panic disorder. Patients with illness phobia before the onset of panic disorder reported higher levels of anticipatory anxiety in nonagoraphobic situations and more depersonalization and derealization during panic attacks, and they met our definition of phobic-anxious temperament more frequently than the rest of the sample. This would suggest that illness phobia before the onset of panic disorder may be viewed either as a separate disorder, a prodrome, or a mild, early-onset form of panic disorder without full-blown attacks. Although patients with premorbid illness phobia are more likely to develop hypochondriasis after the onset of panic disorder, approximately 40% of them do not; therefore, illness phobia should not be considered the only factor that influences the development of hypochondriasis during panic disorder.
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PMID:Hypochondriasis and illness phobia in panic-agoraphobic patients. 905 32

Several studies which focus on the clinical study of the panic disorder have shown its clinical variety, subject to individual variations and which, up to a certain point, may justify a different response to the treatment used. In this sense, but focused on the presence of the depersonalization symptom we have directed our study to see if depersonalization is associated to socio-demographic characteristics, clinical and or personality traits which allow us to differentiate two sub-types of this disorder. Twenty-eight patients with panic disorder completed a structured interview which included a list of symptoms from the Structured Clinical Interview for DSM-III -Upjohn version, together with impairment in social or occupational functions. Fisher's Exact Test and Student's T test were used to analyse the results and showed for depersonalization an earlier onset (p < 0.05) and a more important impairment (p = 0.0021). Thus, the most important conclusion we have reached is an association between depersonalization, an earlier onset of the panic disorder and a more important impairment.
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PMID:[Depersonalization in panic disorders]. 938 60

The question of whether organic conditions, such as complex partial seizures, can cause dissociative symptoms is controversial. Although a diagnostic category for organic dissociation is included in the tenth edition of International Classification of Disease, it has never been identified in the Diagnostic and Statistical Manual. Its inclusion in the upcoming DSM-IV is currently under debate. This article surveys representative literature regarding the role of organic factors in the causation of dissociative symptoms and considers the differential diagnosis of organic dissociation from current and historic perspectives. Dissociative symptoms and disorders (including amnesia, fugue, depersonalization, multiple personality, automatisms, and certain furors) can be induced by a variety of medications, drugs of abuse, and medical illnesses or conditions affecting cerebral function. Organic dissociation can be distinguished from intoxication, amnestic disorder, and delirium. Psychiatric nosology and our conceptualization of altered mental states and functions would benefit from use of the concept of an organic dissociative syndrome, which has clinical, neurophysiologic, and medicolegal significance. Such a category should be included in DSM-IV.
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PMID:The concept of an organic dissociative syndrome: what is the evidence? 938 42

Panic disorder is a chronic and debilitating illness. In this article, we present an algorithm of the diagnosis and treatment of the illness. We place much importance upon the patient variables associated with the treatment decisions. We emphasize strong patient involvement in treatment as a way to become panic free and improve level of functioning. Panic disorder is defined in DSM-IV1 as "The presence of recurrent panic attacks followed by at least one month of persistent concern about having another panic attack, worry about the possible implications or consequences of the panic attack, or a significant behavioral change related to the attacks." A panic attack is defined as "a discrete period of intense fear or discomfort, in which four or more of the following symptoms developed abruptly and reached a peak within 10 minutes." 1) Palpitations, pounding heart or accelerated heart rate; 2) sweating; 3) trembling or shaking; 4) sensations of shortness of breath or smothering; 5) feeling of choking; 6) chest pain or discomfort; 7) nausea or abdominal distress; 8) feeling dizzy, unsteady, light-headed or faint; 9) derealization or depersonalization; 10) fear of losing control or going crazy; 11) fear of dying; 12) paresthesias; 13) chills or hot flashes. The following hypotheses have been used to conceptualize panic disorder from a psychiatrist's perspective.
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PMID:Panic disorder: a different perspective. 949 26

Depersonalization disorder comprises one of the four major dissociative disorders and yet remains poorly studied. There are no reports describing the application of dissociation scales to this population. Our goal was to investigate the applicability of four such scales to depersonalization disorder and to establish screening criteria for the disorder. Two general dissociation scales and two depersonalization scales were administered to 50 subjects with DSM-III-R depersonalization disorder and 20 healthy control subjects. The depersonalization disorder group scored significantly higher than the normal control group in all scales and subscales. Factor analysis of the Dissociative Experiences Scale (DES) yielded three factors as proposed previously, absorption, amnesia, and depersonalization/derealization. A DES cutoff score of 12, markedly lower than those previously proposed for the screening of other dissociative disorders, is required for the sensitive detection of depersonalization disorder. Alternatively, the DES pathological dissociation taxon (DES-taxon) score recently generated in the literature appears more sensitive to the detection of depersonalization disorder and is better recommended for screening purposes. The other three scales were fairly strongly correlated to the DES, suggesting that they may measure similar but not identical concepts, and cutoff scores are proposed for these scales also. General implications for the screening and quantification of depersonalization pathology are discussed.
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PMID:The detection and measurement of depersonalization disorder. 974 59


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