|
Depersonalization disorder (DPD) is a mental disorder in which the sufferer has persistent or recurrent feelings of depersonalization and/or derealization. In the DSM-5 it was combined with Derealization Disorder and renamed to Depersonalization/Derealization Disorder (DDPD). In the DSM-5 it remains classified as a dissociative disorder, while in the ICD-10 it is called depersonalization-derealization syndrome and classified as a neurotic disorder.〔World Health Organisation http://apps.who.int/classifications/icd10/browse/2010/en#/F48.1〕 Symptoms can be classified as either depersonalization or derealization. Depersonalization is described as feeling disconnected or estranged from one's body, thoughts, or emotions. Individuals experiencing depersonalization may report feeling as if they are in a dream or are watching themselves in a movie. They may feel like an outside observer of their own thoughts or body, and often report feeling a loss of control over their thoughts or actions. In some cases, individuals may be unable to accept their reflection as their own, or they may have out-of-body experiences.〔 While depersonalization is a sense of detachment from one's self, derealization is described as detachment from one's surroundings. Individuals experiencing derealization may report perceiving the world around them as foggy, dreamlike/surreal, or visually distorted.〔 In addition to these depersonalization-derealization disorder symptoms, the inner turmoil created by the disorder can result in depression, self-harm, low self-esteem, anxiety attacks, panic attacks, phobias, etc. It can also cause a variety of physical symptoms, including chest pain, blurry vision, nausea, and the sensation of pins and needles in one's arms or legs. Diagnostic criteria for depersonalization-derealization disorder includes, among other symptoms, persistent or recurrent feelings of detachment from one's mental or bodily processes or from one's surroundings.〔 A diagnosis is made when the dissociation is persistent and interferes with the social and/or occupational functions of daily life. However, accurate descriptions of the symptoms are hard to provide due to the subjective nature of depersonalization/derealization and sufferers' ambiguous use of language when describing these episodes. Depersonalization-derealization disorder is thought to be caused largely by severe traumatic lifetime events, including childhood abuse, accidents, natural disasters, war, torture, and bad drug experiences. It is unclear whether genetics play a role; however, there are many neurochemical and hormonal changes in individuals suffering with depersonalization disorder. The disorder is typically associated with cognitive disruptions in early perceptual and attentional processes. Although the disorder is an alteration in the subjective experience of reality, it is not a form of psychosis, as sufferers maintain the ability to distinguish between their own internal experiences and the objective reality of the outside world. During episodic and continuous depersonalization, sufferers can distinguish between reality and fantasy. In other words, their grasp on reality remains stable at all times.〔Simeon and Abugel p. 32 & 133〕 While depersonalization-derealization disorder was once considered rare, lifetime experiences with the disorder occur in approximately 1%–2% of the general population. The chronic form of this disorder has a reported prevalence of 0.1 to 1.9%〔Cannabis-induced depersonalization disorder in adolescence. Hürlimann F1, Kupferschmid S, Simon AE. ("Although depersonalization disorder has a low prevalence, with a reported prevalence ranging from 0.8 to 1.9%")〕 While these numbers may seem small, depersonalization/derealization experiences have been reported by a majority of the general population, with varying degrees of intensity. While brief episodes of depersonalization or derealization can be common in the general population, the disorder is only diagnosed when these symptoms cause significant distress or impair social, occupational, or other important areas of functioning. ==Symptoms== The core symptom of depersonalization-derealization disorder is the subjective experience of "unreality in one's sense of self," or detachment from one's surroundings. People who are diagnosed with depersonalization also experience an urge to question and think critically about the nature of reality and existence.〔 Individuals who experience depersonalization can feel divorced from their own personal physicality by sensing their body sensations, feelings, emotions and behaviors as not belonging to themselves. As such, a recognition of one's self breaks down. Depersonalization can result in very high anxiety levels, which can intensify these perceptions even further. Individuals with depersonalization describe feeling disconnected from their physicality; feeling as if they are not completely occupying their own body; feeling as if their speech or physical movements are out of their control; feeling detached from their own thoughts or emotions; and experiencing themselves and their lives from a distance.〔 While depersonalization involves detachment from one's ''self'', individuals with derealization feel detached from their ''surroundings'', as if the world around them is foggy, dreamlike, or visually distorted. Some people suffering from depersonalization disorder also have visual alterations such as rapid fluctuations in light. While the exact cause of these perceptual changes has not been determined, it is thought that they may be due to previous drug use. These perceptual changes differ from true hallucinatory phenomena, as they are closer to being optical distortions or illusions rather than psychotic breaks from reality.〔 Individuals with the disorder commonly describe a feeling as though time is "passing" them by and they are not in the notion of the present. These experiences which strike at the core of a person's identity and consciousness may cause a person to feel uneasy or anxious. Factors that tend to diminish symptoms are comforting personal interactions, intense physical or emotional stimulation, and relaxation. Distracting oneself (by engaging in conversation or watching a movie, for example) may also provide temporary relief. Some other factors that are identified as relieving symptom severity are diet and/or exercise, while alcohol and fatigue are listed by some as worsening their symptoms. First experiences with depersonalization may be frightening, with patients fearing loss of control, dissociation from the rest of society and functional impairment.〔 The majority of patients suffering from depersonalization-derealization disorder misinterpret the symptoms, thinking that they are signs of serious mental illness or brain dysfunction. This commonly leads to an increase of anxiety experienced by the patient, and obsession, which contributes to the worsening of symptoms. Occasional, brief moments of mild depersonalization can be experienced by many members of the general population;〔Simeon, D., & Abugel, J. (2006). ''Feeling Unreal: Depersonalization Disorder and the Loss of the Self''. New York, NY: Oxford University Press. (p. 3)〕 however, depersonalization-derealization disorder occurs when these feelings are strong, severe, persistent, or recurrent and when these feelings interfere with daily functioning. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Depersonalization disorder」の詳細全文を読む スポンサード リンク
|