Depersonalization/Derealization Disorder
Persistent or recurrent episodes of detachment from the self (depersonalization) or surroundings (derealization), with intact reality testing.
DSM-5-TR Code
F48.1
Etiology (Biopsychosocial Model)
Biological: Abnormal sensory gating, HPA axis dysfunction
Psychological: Emotional suppression, early neglect
Social: Interpersonal trauma, panic attacks, drug use (e.g., cannabis)
Prevalence
Lifetime prevalence ~1–2%; onset typically in adolescence
Symptoms & Diagnosis (Mnemonic: DREAM)
- D - Detachment from self or world
- R - Reality testing intact
- E - Experiences cause distress or impairment
- A - Absence of substance or medical cause
- M - Must not be better explained by other disorders
Treatment
- CBT with grounding techniques
- SSRIs if comorbid anxiety/depression
- Psychoeducation and anxiety management
Info
DSM-5-TR Code
F48.1
Prevalence
Lifetime: ~1–2%
Onset: adolescence