Abstract
The symptoms of dissociation, depersonalization and derealization are often associated with exposure of patients to mental and physical injuries, usually occurring in childhood. Most of these observations were carried out in populations of patients with various disorders (posttraumatic, conversion-dissociation, personality disorders - especially borderline), who reported their exposure to adverse life circumstances through questionnaire interviews. Assessment of the risk associated with various traumatic events in childhood and adolescence concerning the symptoms of pain and tactile dissociation, depersonalization and derealization. The coexistence of the earlier life circumstances and the currently existing symptoms was examined on the basis of KO "0" Symptom Checklist and Life Inventory, completed prior to treatment in a day hospital for neurotic disorders. In the group of 2582 women, patients of a day hospital for neurotic and personality disorders, the symptoms of pain and tactile dissociation, depersonalization and derealization were present in 24-36 % of patients, while the maximum severity of these symptoms reported approximately 4-8 % of patients. The studied patients reported the exposure during childhood and adolescence (before 18yo) to numerous traumatic events of varying severity and frequency, including hostility of one parent (approximately 5% of respondents), the sexual initiation before 13yo (1%), worse than peers material conditions (23%), harassment of the family of origin (2%), reluctance of their peers (9%). Conducted regression analysis showed illustrated by the coefficients OR (odds ratios) a statistically significant relationship between the majority of the analyzed symptoms and many of the listed events, such as being regarded as worse than siblings, mother's anger in the situation of the patient's disease in childhood, lack of support, indifference of parent, poverty and worseness of the family of origin, inferior position in the classroom and the school grades, total sexual unawareness, incest or its attempt. The symptoms of dissociation, depersonalization and derealization occurred in significantly more patients reporting burdening life events - difficult situations in childhood and adolescence. Therefore, in clinical practice in patients presenting such symptoms, regardless of diagnosis (e. g. a specific neurotic disorder), we can expect revealing information about such events.
Highlights
According to ICD-10 classification the depersonalization – derealization syndrome belongs to the category of “other” neurotic disorders
The symptoms of dissociation, depersonalization and derealization occurred in significantly more patients reporting burdening life events – difficult situations in childhood and adolescence
In the group of 2,582 women treated in day hospital, there was a significant prevalence of dissociative symptoms affecting the feeling of pain or touch and depersonalization-derealization experiences
Summary
According to ICD-10 classification the depersonalization – derealization syndrome belongs to the category of “other” neurotic disorders. It consists in experiencing one’s own mental activity, the body or the environment as unreal, strange, automated, which may be accompanied by emotional coldness, a feeling of strangeness and separation from one’s own thoughts, the body or the real world. The basic changes made with the introduction of DSM-5 consist on the division of the group of dissociative symptoms to the “positive” :experiencing fragmentation of identity, depersonalization and derealization, and “negative” − associated with lack of access to or control (memory, movement, etc.) [5−8]
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