Simeon Daphne, Stein Dan J
, 275 Central Park West, Suite 1A, New York, NY, 10024, USA.
SAMRC Unit on Risk and Resilience on Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
Soc Psychiatry Psychiatr Epidemiol. 2025 May 3. doi: 10.1007/s00127-025-02915-2.
Depersonalization/derealization (dpdr) is known to occur across mood and anxiety disorders (MAD) and has been proposed as a marker of worse illness. However, despite the well-known clinical association, there are no epidemiological data on the relationship between dpdr and MAD.
In this NCS-R analysis clinically significant dpdr (DPDR-C) was defined as "sometimes" or "often" past-month endorsement of depersonalization and/or derealization in the absence of other pathological dissociation. Six past-month MAD diagnoses were examined: DSM-IV generalized anxiety disorder, panic disorder, social phobia, major depression, bipolar I, and bipolar II. RESULTS: National DPDR-C one-month prevalence was 0.9%. After excluding all cases with past-month posttraumatic stress disorder or non-dpdr pathological dissociation, 21.2% of DPDR-C cases were accounted for by MAD while 3.0% of MAD cases endorsed DPDR-C, ranging from 0% (generalized anxiety disorder) to 11.8% (comorbid mood and anxiety disorder). DPDR-C was not uniquely related to any MAD disorder, and was not associated with MAD age of onset, chronicity, or impairment. Rather, DPDR-C was significantly associated with number of comorbid MAD disorders and with mood/anxiety comorbidity.
At the epidemiologic level DPDR-C was uncommon in MAD but was more likely to occur in the presence of combined mood and anxiety disturbance, which may cause greater disruption to the usual sense of self and thus trigger unreality experiences.
人格解体/现实解体（dpdr）在情绪和焦虑障碍（MAD）中均有发生，并且被认为是病情较重的一个标志。然而，尽管这种临床关联广为人知，但关于dpdr与MAD之间关系的流行病学数据却并不存在。
在这项全国共病调查-复制（NCS-R）分析中，具有临床意义的dpdr（DPDR-C）被定义为在过去一个月内“有时”或“经常”出现人格解体和/或现实解体，且不存在其他病理性解离。对过去一个月内的六种MAD诊断进行了检查：《精神疾病诊断与统计手册》第四版（DSM-IV）中的广泛性焦虑障碍、惊恐障碍、社交恐惧症、重度抑郁症、双相I型障碍和双相II型障碍。
全国范围内DPDR-C的一个月患病率为0.9%。在排除所有过去一个月内患有创伤后应激障碍或非dpdr病理性解离的病例后，21.2%的DPDR-C病例由MAD导致，而3.0%的MAD病例认可DPDR-C，范围从0%（广泛性焦虑障碍）到11.8%（共病情绪和焦虑障碍）。DPDR-C并非与任何一种MAD障碍有独特关联，也与MAD的发病年龄、慢性病程或损害无关。相反，DPDR-C与共病MAD障碍的数量以及情绪/焦虑共病显著相关。
在流行病学层面，DPDR-C在MAD中并不常见，但在存在合并的情绪和焦虑障碍时更有可能发生，这可能会对通常的自我感觉造成更大干扰，从而引发现实解体体验。
