Derealization

Derealization (DR) is a complex and perplexing dissociative disorder characterized by an alteration in the perception or experience of the external world, causing it to appear unreal. Along with feelings of unreality, individuals with derealization may also experience their environment as lacking spontaneity, emotional resonance, and depth.

Introduction

The term "derealization" is derived from the French word "dé-réalisation," initially used in the psychiatric literature by the French psychiatrist Ludovic Dugas in 1898. It denotes a sense of estrangement or alteration in one's perception of the environment.

Derealization vs. Depersonalization

While often used interchangeably, derealization and depersonalization represent distinct yet closely related concepts. Derealization pertains to the experience of the external world appearing unreal, while depersonalization refers to a sense of unreality or estrangement from one's self. However, the two often occur together, and the distinction is not universally recognized by all authors in the field.

Causes and Pathophysiology

Derealization can be a symptom of various conditions, including psychiatric and neurological disorders, as well as a common reaction to severe stress or trauma. Chronic derealization may be caused by dysfunction in the occipital–temporal regions of the brain, which are responsible for processing visual and auditory information, respectively.

Prevalence

Derealization symptoms are more common than one might expect. The lifetime prevalence in the general population is up to 5%. This figure significantly increases at the time of a traumatic event, with 31–66% of individuals reporting experiences of derealization.

Diagnosis and Treatment

Diagnosis of derealization involves a comprehensive psychiatric evaluation and the exclusion of other potential medical, neurological, and psychiatric conditions that could be causing the symptoms. Treatment typically involves a combination of psychotherapy, such as cognitive-behavioral therapy (CBT), and medication to manage any underlying disorders, such as depression or anxiety, that may contribute to the derealization symptoms.

See Also

• Dissociative disorder
• Depersonalization disorder
• Occipital lobe
• Temporal lobe

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