A 20-Year Descriptive Phenomenological Study of Depersonalization and Derealization as an Alteration in Sense of Self and Lifeworld.
Schizophrenia bulletin April 10, 2026 Cherise Rosen, Liping Tong, Julia G Lebovitz et al.
Depersonalization (DP) and derealization (DR) are alterations in sense of self and lifeworld that often co-occur in psychosis. Over 20 years, the Chicago Longitudinal Study examined these phenomena across psychiatric categories. DP was broadly distributed across diagnoses, while DR showed greater specificity to schizophrenia. Network analyses revealed three foundational constructs in schizophrenia: alteration in sense of self/lifeworld, multisensory experiences, and bodily experiences; bodily and multisensory alterations were foundational in affective-psychosis. Self-disturbance emerged as foundational only in schizophrenia. The findings support reframing DP and DR as points on a continuum of attenuated alterations in sense of self and lifeworld, representing a fundamental self-disturbance in existential feeling.