However, the disorder is severely underdiagnosed. Epidemiological surveys suggest that the current prevalence rate of the depersonalization-derealization syndrome is approximately 1 % in the general population. The typical DDS patient, reports that the disorder started before age 25, and that the DP/DR symptoms are present all day long since several years. Further, symptoms of depersonalization and derealization are not better explained by another mental disorder or medical condition and the symptoms cause significant impairment (DSM-5 ). Depersonalization-derealization syndrome (DDS) is defined by feeling detached from the own feelings and/or experiences (depersonalization, DP) and/or experiencing objects, people, and/or surroundings as unreal, distant, artificial, and lifeless (derealization, DR) while reality testing remains intact (ICD-10 ). In view of the size of the problem, more research on the disorder, its course and its optimal treatment is urgently required.ĭepersonalization-derealization syndrome as named in the ICD-10 (or depersonalization-derealization disorder as termed in the DSM-5 is an underresearched clinical phenomenon.
DDS patients are severely impaired, utilizing mental health care to a high degree, which nevertheless might not meet their treatment needs, as patients strongly opt for obtaining disorder specific counseling. In consideration of the selection bias of this study, this case series supports the view that the course of the DDS tends to be long-lasting. However, they reported a family history of anxiety disorders more often. DDS patients had lower levels of self-rated traumatic childhood experiences and current psychosocial stressors. Nearly all DDS patients endorsed the wish for a symptom specific counseling and 70.7 % were interested in the internet-based treatment of their problems. They had higher rates of previous or current mental health care utilization. They tended to show more severe functional impairment. DDS patients were younger, had a significant preponderance of male sex, longer disease duration and an earlier age of onset, a higher education but were more often unemployed. Resultsĭespite the high comorbidity of DDS patients with depressive disorders and comparable burden with symptoms of depression and anxiety, the clinical picture and course of both patient groups differed strongly. DDS patients were described and compared with depressive outpatients in terms of sociodemographic characteristics, treatment history, treatment wishes, clinical symptomatology, prevailing psychosocial stressors, family history of common mental disorders and history of childhood trauma. The sample comprised 223 patients with a diagnosis of depersonalization-derealization-syndrome and 1129 patients with a depressive disorder but without a comorbid diagnosis of DDS. To reveal differential characteristics, we compared the DDS patients, who consulted the specialized depersonalization-derealization clinic, with a group of patients with depressive disorders without comorbid DDS from the regular outpatient clinic of the mental health center. Against this background, we carried out a large comprehensive survey of a DDS series in a tertiary mental health center with a specialized depersonalization-derealization clinic. In Germany, its administrative prevalence is far below the threshold for orphan diseases, although according to epidemiological surveys the diagnosis should be comparable frequent as anorexia nervosa for instance. Depersonalization-derealization syndrome (DDS) is an underdiagnosed and underresearched clinical phenomenon.
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