Depersonalisation

Depersonalisation is a subjective feeling of altered reality of the self. The patient feels that they are not their normal self and may complain of wanting to 'wake up' from their present state and of feeling 'unreal'. It is sometimes described as a feeling like an actor performing on a stage.

• DSM–IV describes depersonalisation as:

‘alteration in the perception or experience of the self so that one feels detached from and as if one is an outside observer of one’s mental processes or body’ (1)
Depersonalisation symptoms may be present:

• in many neurological conditions e.g. migraine and epilepsy
• in psychiatric conditions e.g. major depression, panic disorder, posttraumatic stress disorder, schizophrenia, stress and fatigue
• as a primary condition - depersonalisation-derealisation disorder

Depersonalisation disorder (DPRD) is characterised by persistent or recurrent depersonalization often accompanied by derealisation (2)

In majority of cases both depersonalisation and derealisation occur together.

• in ICD-10, it is described together in the diagnostic category depersonalisation–derealisation syndrome

‘in which the sufferer complains that his or her mental activity, body, and/or surroundings are changed in their quality, so as to be unreal, remote, or automatized’

• in DSM-V, DPRD has been renamed as depersonalisation-derealisation disorder (3)

Reference:

• (1) Medford N et al. Understanding and treating depersonalisation disorder. Advances in Psychiatric Treatment (2005), vol. 11, 92–100
• (2) Michal M et al. Depersonalization disorder: disconnection of cognitive evaluation from autonomic responses to emotional stimuli. PLoS One. 2013;8(9):e74331.
• (3) Somer E, Amos-Williams T, Stein DJ. Evidence-based treatment for Depersonalisation-derealisation Disorder (DPRD). BMC Psychol. 2013;1(1):20.