Unraveling the Enigma: Clinical Research on Depersonalization Disorder

Depersonalization disorder (DPD) is frequently misdiagnosed or underdiagnosed in psychiatry. Patients often present with accompanying anxiety or depression, but they distinguish their core experience—feelings of unreality, deadness, or having no self—from those conditions. Clinicians may misattribute these symptoms to anxiety or depression due to their training and comfort with those domains, leading to inappropriate treatment.

Study at a glance

Abstract

Abstract The human brain, the only organ capable of studying itself, has in the last century turned its attention toward the mysterious phenomenon of depersonalization, examining it from many perspectives. Depersonalization disorder (DPD) remains one of the most frequently misdiagnosed or underdiagnosed conditions in modern psychiatry. Why? Likely for several reasons. DPD is often accompanied by anxiety, depression, or other disorders, and patients may have trouble or hesitation expressing its vagaries in words that anyone but fellow sufferers can understand. Patients often wind up being treated for depression or anxiety, even though they have tried to make clear that they were depressed or anxious only initially in their depersonalization course, or only well after depersonalization had set in. The patients are often clear that what they are struggling most with are feelings of “unreality,” “deadness,” or “no self” and that they know the difference from being solely depressed or anxious. Clinicians, however, do not always agree, possibly because they have solid training in—and are more comfortable dealing with—the domains of anxiety and depression.