Michal Matthias, Beutel Manfred E
Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Johannes Gutenberg Universität Mainz, D-55131 Mainz, Germany.
Z Psychosom Med Psychother. 2009;55(2):113-40. doi: 10.13109/zptm.2009.55.2.113.
The present state of knowledge about depersonalization (DP) and derealization (DR) is reviewed with respect to classification, epidemiology, etiology, and therapy. Mild and transient DP-DR are considered to be common phenomena. The prevalence of depersonalization-derealization disorder (DP-DR-D) is estimated to be approx. 1-2% of the general population in the Western hemisphere. DP-DR-D is probably severely underdiagnosed. DP-DR-D is strongly associated with depression and anxiety disorders. It is suggested that symptoms of DP-DR indicate disease severity and negatively predict therapy outcome. Neurobiological and psychological models have shown that a disordered body schema and emotional and autonomic blunting are essential components of the disorder. Despite the frequency of DPDR and its clinical relevance, there is a considerable lack of empirical research on DP-DR with respect to the health-care situation of depersonalized patients and with regard to treatment options.
本文就人格解体（DP）和现实解体（DR）的分类、流行病学、病因及治疗方面对当前的知识现状进行了综述。轻度和短暂的DP-DR被认为是常见现象。据估计，人格解体-现实解体障碍（DP-DR-D）在西半球普通人群中的患病率约为1%-2%。DP-DR-D可能严重漏诊。DP-DR-D与抑郁症和焦虑症密切相关。有研究表明，DP-DR症状提示疾病严重程度，并对治疗结果有负面预测作用。神经生物学和心理学模型显示，紊乱的身体图式以及情绪和自主神经迟钝是该障碍的重要组成部分。尽管DP-DR很常见且具有临床相关性，但在人格解体患者的医疗状况及治疗选择方面，关于DP-DR的实证研究仍相当匮乏。
