The epidemiology of depersonalisation and derealisation
Abstract
Background Symptoms of depersonalisation (DP) and derealisation (DR) are increasingly recognised in both clinical and non-clinical settings, but their importance and underlying pathophysiology is only now being addressed.Methods This paper is a systematic review of the current state of knowledge about the prevalence of depersonalisation and derealisation using computerised databases and citation searches. All potential studies were examined and numerical data included. Three categories of study are reviewed: questionnaire and interview surveys of selected student and non-clinical samples; population-based community surveys using standardised diagnostic interviews; and clinical surveys of depersonalisation/derealisation symptoms occurring within inpatients with psychiatric disorders. In addition, we present newly analysed data of the prevalence of depersonalisation/derealisation from five large population-based studies.Results Epidemiological surveys demonstrate that transient symptoms of depersonalisation/derealisation in the general population are common, with a lifetime prevalence rate of between 26 and 74% and between 31 and 66% at the time of a traumatic event. Community surveys employing standardised diagnostic interviews reveal rates of between 1.2 and 1.7 % for one month prevalence in a UK sample and a 2.4% current prevalence rate in a Canadian sample. Current prevalence rates in samples of consecutive inpatient admissions are reported between 1 and 16%, although screening measures employed may have resulted in these being an underestimate. Prevalence rates in clinical samples of specific psychiatric disorders vary between 30% of war veterans with PTSD and 60% of those with unipolar depression. There is a high prevalence within panic disorder with rates varying from 7.8 to 82.6%.Discussion DP and DR symptoms are common in normal and psychiatric populations, but prevalence estimates are hampered by inconsistent definitions and the use of variable time-frames. Population-based surveys using diagnostic interviews yield prevalence rates of clinically significant DP/DR in the region of 1-2%. Surveys of clinical populations in which common screening and assessment instruments were used also yield consistently high prevalence rates. The use of reliable diagnostic assessments and rating scales is needed. The relationship between DP/DR and certain other psychiatric disorders (e. g. panic) suggests possible common pathophysiological or aetiological factors.
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Lifetime prevalence rates of transient depersonalisation symptoms in the general population are between 26 and 74%.
“Epidemiological studies suggest lifetime prevalence rates of transient depersonalisation symptoms in the general population of between 26 and 74 % [11].”
From A brief CBT intervention for depersonalisation/derealisation in psychosis: Study protocol for a feasibility randomised controlled trial (2016) · cites this paper as [11]
One-month prevalence rates of depersonalisation disorder (DPD) in community surveys using standardised diagnostic criteria are between 1.2 and 2.4%.
“Community surveys examining the prevalence of DPD specifically, using standardised diagnostic criteria, suggest 1 month prevalence rates of between 1.2 and 2.4 %, and rates as high as 82.6 % have been reported comorbid with other psychiatric disorders [11].”
From A brief CBT intervention for depersonalisation/derealisation in psychosis: Study protocol for a feasibility randomised controlled trial (2016) · cites this paper as [11]
Rates as high as 82.6% have been reported for DPD comorbid with other psychiatric disorders.
“Community surveys examining the prevalence of DPD specifically, using standardised diagnostic criteria, suggest 1 month prevalence rates of between 1.2 and 2.4 %, and rates as high as 82.6 % have been reported comorbid with other psychiatric disorders [11].”
From A brief CBT intervention for depersonalisation/derealisation in psychosis: Study protocol for a feasibility randomised controlled trial (2016) · cites this paper as [11]
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Delusions of Death in a Patient with Right Hemisphere Infarction
Nishio, Y., & Mori, E. (2012) · Cognitive and Behavioral Neurology · doi:10.1097/wnn.0b013e31827504c7 · Cited by 25 · see citing works
Evidence-based treatment for Depersonalisation-derealisation Disorder (DPRD)
Somer, E., Williams, T., & Stein, D. J. (2013) · BMC Psychology · doi:10.1186/2050-7283-1-20 · Cited by 26 · see citing works
“Lifetime prevalence of depersonalisation and derealisation symptoms of 31 and 66% were found in surveys conducted among non-clinical respondents compared to a lifetime prevalence of depersonalisation and derealisation symptoms of 42 to 91% in psychiatric settings (Hunter et al. 2004b).”
BackgroundInfluentialFagioli, F., Telesforo, L., Dell’Erba, A., Consolazione, M., Migliorini, V., Patanè, M., Boldrini, T., Graziani, R., Nicoletti, F., & Nastro, P. F. (2014) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2014.06.007 · Cited by 26 · see citing works
Symptom variability in depersonalization–derealization disorder: A latent profile analysis
Millman, L. S. M., Hunter, E. C. M., Orgs, G., David, A. S., & Terhune, D. B. (2021) · Journal of Clinical Psychology · doi:10.1002/jclp.23241 · Cited by 25 · see citing works
Self-citationMichal, M., Beutel, M. E., & Grobe, T. (2010) · Zeitschrift für psychosomatische Medizin und Psychotherapie · doi:10.13109/zptm.2010.56.1.74 · Cited by 26 · see citing works
Simeon, D., & Putnam, F. (2022) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2022.2064580 · Cited by 24 · see citing works
Laoide, A. Ó., Egan, J., & Osborn, K. A. R. (2017) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2017.1402398 · Cited by 26 · see citing works
Weiterbildung CME: Depersonalisation/Derealisation - Krankheitsbild, Diagnostik und Therapie
Michal, M., & Beutel, M. E. (2009) · Zeitschrift für psychosomatische Medizin und Psychotherapie · doi:10.13109/zptm.2009.55.2.113 · Cited by 25 · see citing works
The Effect of Haptic Prediction Accuracy on Presence
Gall, D., & Latoschik, M. E. (2018) · IEEE Conference on Virtual Reality and 3D User Interfaces (VR) · doi:10.1109/vr.2018.8446153 · Cited by 27 · see citing works
“The condition is a poorly understood and under-researched dissociative syndrome, although high prevalence rates are observed [22].”
BackgroundSchultze‐Lutter, F., Walger, P., Franscini, M., Traber‐Walker, N., Osman, N., Walger, H., SCHIMMELMANN, B. G., Flückiger, R., & Michel, C. (2022) · World Journal of Psychiatry · doi:10.5498/wjp.v12.i3.425 · Cited by 25 · see citing works
Millman, L. S. M., Hunter, E. C. M., Terhune, D. B., & Orgs, G. (2023) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2023.101749 · Cited by 27 · see citing works
“Transient, short-lived experiences of DD are relatively common in the general population, with an estimated prevalence of 23% [13], and can occur as a result of fatigue, substance abuse, or trauma [14].”
BackgroundSelf-citationCannabis-Induced Depersonalization Disorder in Adolescence
Hürlimann, F., Kupferschmid, S., & Simon, A. E. (2012) · Neuropsychobiology · doi:10.1159/000334605 · Cited by 24 · see citing works
Depersonalization in Psychiatric Patients
Sierra, M., Gomez, J., Molina-Castillo, J. J., Luque, R., oz, J. F. M., & David, A. S. (2006) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000218071.32072.74 · Cited by 24 · see citing works
“Depersonalization occurs in association with diverse neuropsychiatric conditions (Hunter et al., 2004; Lambert et al., 2002), or as a primary disorder, in which case it tends to run a chronic and disabling course (Baker et al., 2003; Simeon et al., 2003a).”
BackgroundResultSelf-citationGago-Valiente, F.-J., Sierra, M. I. M., Sánchez, E. M., Arbinaga, F., & Segura-Camacho, A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18157860 · Cited by 23 · see citing works
Self-citationBarreda-Ángeles, M., & Hartmann, T. (2023) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2022.0152 · Cited by 21 · see citing works
“To further enrich our insights into the potential effects of VR use on DPDR, this study presents the results of an online survey of VR application users that examines these questions, providing a first account of the association between VR use and long-term DPDR symptoms among users in real-world settings.”
InfluentialMula, M. (2008) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s3622 · Cited by 22 · see citing works
“The prevalence of DPD in our sample is in line with that reported in the general population and slightly under that reported in clinical samples (Hunter et al 2004).”
BackgroundResultInfluentialDetached and distracted: ERP correlates of altered attentional function in depersonalisation
Schabinger, N., Gillmeister, H., Berti, S., Michal, M., Beutel, M. E., & Adler, J. (2018) · Biological Psychology · doi:10.1016/j.biopsycho.2018.02.014 · Cited by 21 · see citing works
“The prevalence of DP in the general population is around 1-2% with both genders equally affected (Hunter et al., 2004; Lee et al., 2012; Simeon, 2004).”
Background
- Authors
- Sierra, M., David, A. S., & Hunter, E. C. M.
- Corresponding author
- David, A. S.
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2004-01-01
- Volume
- 39
- Issue
- 1
- Pages
- 9-18
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- OpenAlex
- W110894270
- Cited by
- 316
- References
- 0
- Citations by year
- 2026: 16 · 2025: 17 · 2024: 35 · 2023: 20 · 2022: 23 · 2021: 16 · 2020: 12 · 2019: 11 · 2018: 13 · 2017: 11 · 2016: 17 · 2015: 12 · 2014: 17 · 2013: 7 · 2012: 17
- FWCI
- 6.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- depersonalization, derealization, prevalence, lifetime prevalence, mental illness, panic disorder, post-traumatic stress disorder, major depressive disorder, war veterans, psychiatric inpatients, community prevalence, diagnostic assessment
- MeSH terms
- Adult, Mental Disorders, Depersonalization, Dissociative Disorders, Hospitalization, Hospitals, Psychiatric, Humans, Middle Aged, Surveys and Questionnaires, Stress Disorders, Post-Traumatic, Prevalence, Panic Disorder
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