nach oben

Social Psychiatry and Psychiatric Epidemiology

Erschienen in:

01.06.2015 | Original Paper

Prevalence and correlates of depersonalization in students aged 12–18 years in Germany

verfasst von: Matthias Michal, Eva Duven, Sebastian Giralt, Michael Dreier, Kai W. Müller, Julia Adler, Manfred E. Beutel, Klaus Wölfling

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 6/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

Depersonalization (DP) involves unpleasant experiences of detachment from one’s sense of self or unreality in the environment. DP may occur in a broad range of conditions, among healthy persons due to sleep loss, drug induced, secondary to anxiety disorders or primary in depersonalization disorder. Although DP has an early age of onset, little is known about the prevalence and correlates of DP among adolescents.

Methods

Between January and June 2011, we conducted a questionnaire-based representative survey of pupils aged 12–18 years in the federal state Rhineland-Palatinate of Germany. The final sample comprised 3,809 pupils. We analyzed the prevalence of depersonalization and its correlates regarding sociodemographic characteristics, substance abuse, global mental distress and resilience factors.

Results

One-third of the sample showed severe global mental distress, and 11.9 % were in the range of clinically significant depersonalization. Depersonalized students were less often living with both parents (67.3 vs. 75.7 %), came more often from an disadvantaged socioeconomic background, had a very severe level of global mental distress (comparable to psychiatric inpatients), were more often smoking and abusing cannabis and they suffered from specific impairments regarding social insecurity, global self-efficacy and active coping abilities.

Conclusions

Experiences of depersonalization were very common among adolescents and may indicate an increased risk for poor academic achievement and mental health in the long term. Prospective studies are needed to investigate the course and clinical relevance of depersonalization for the development of the adolescents.

Hoyer J, Braeuer D, Crawcour S, Klumbies E, Kirschbaum C (2013) Depersonalization/derealization during acute social stress in social phobia. J Anxiety Disord 27(2):178–187. doi:10.1016/j.janxdis.2013.01.002 CrossRefPubMed

Michal M, Wiltink J, Till Y, Wild PS, Blettner M, Beutel ME (2011) Distinctiveness and overlap of depersonalization with anxiety and depression in a community sample: results from the Gutenberg Heart Study. Psychiatry Res 188(2):264–268. doi:10.1016/j.psychres.2010.11.004 (pii:S0165-1781(10)00694-3)CrossRefPubMed

American-Psychiatric-Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Publishing, Inc, ArlingtonCrossRef

Hunter EC, Sierra M, David AS (2004) The epidemiology of depersonalisation and derealisation. A systematic review. Soc Psychiatry Psychiatr Epidemiol 39(1):9–18. doi:10.1007/s00127-004-0701-4 CrossRefPubMed

Lee WE, Kwok CH, Hunter EC, Richards M, David AS (2012) Prevalence and childhood antecedents of depersonalization syndrome in a UK birth cohort. Soc Psychiatry Psychiatr Epidemiol 47(2):253–261. doi:10.1007/s00127-010-0327-7 CrossRefPubMedCentralPubMed

Michal M, Wiltink J, Subic-Wrana C, Zwerenz R, Tuin I, Lichy M, Brahler E, Beutel ME (2009) Prevalence, correlates, and predictors of depersonalization experiences in the German general population. J Nerv Ment Dis 197(7):499–506. doi:10.1097/NMD.0b013e3181aacd94 ([pii] 00005053-200907000-00005 )CrossRefPubMed

Michal M, Glaesmer H, Zwerenz R, Knebel A, Wiltink J, Brahler E, Beutel ME (2011) Base rates for depersonalization according to the 2-item version of the Cambridge Depersonalization Scale (CDS-2) and its associations with depression/anxiety in the general population. J Affect Disord 128(1–2):106–111. doi:10.1016/j.jad.2010.06.033 (pii: S0165-0327(10)00461-1)CrossRefPubMed

Armstrong JG, Putnam FW, Carlson EB, Libero DZ, Smith SR (1997) Development and validation of a measure of adolescent dissociation: the adolescent dissociative experiences scale. J Nerv Ment Dis 185(8):491–497CrossRefPubMed

Soukup J, Papezova H, Kubena AA, Mikolajova V (2010) Dissociation in non-clinical and clinical sample of Czech adolescents. Reliability and validity of the Czech version of the adolescent dissociative experiences scale. Eur Psychiatry 25(7):390–395. doi:10.1016/j.eurpsy.2010.03.011 CrossRefPubMed

10.

Muris P, Merckelbach H, Peeters E (2003) The links between the adolescent dissociative experiences scale (A-DES), fantasy proneness, and anxiety symptoms. J Nerv Ment Dis 191(1):18–24. doi:10.1097/01.nmd.0000044441.79471.49 CrossRefPubMed

11.

Resch F (1998) Zur präpsychotischen Persönlichkeitsentwicklung in der Adoleszenz. Psychotherapeut 43(2):111–116CrossRef

12.

Meyer JE (1962) Reifungskrisen der Adoleszenz, ihre Entstehungsbedingungen und ihre Prognose. Eur Arch Psychiatry Clin Neurosci 203(3):235–247

13.

Michal M, Kaufhold J, Overbeck G, Grabhorn R (2006) Narcissistic regulation of the self and interpersonal problems in depersonalized patients. Psychopathology 39(4):192–198. doi:10.1159/000093523 (pii:PSP2006039004192)CrossRefPubMed

14.

Herpertz-Dahlmann B, Buhren K, Remschmidt H (2013) Growing up is hard: mental disorders in adolescence. Dtsch Arztebl Int 110(25):432–439. doi:10.3238/arztebl.2013.0432 (quiz 440)PubMedCentralPubMed

15.

Michal M, Beutel ME, Jordan J, Zimmermann M, Wolters S, Heidenreich T (2007) Depersonalization, mindfulness, and childhood trauma. J Nerv Ment Dis 195(8):693–696. doi:10.1097/NMD.0b013e31811f4492 (pii:00005053-200708000-00010)CrossRefPubMed

16.

Michal M, Wiltink J, Subic-Wrana C, Zwerenz R, Tuin I, Lichy M, Brähler E, Beutel ME (2009) Prevalence, correlates, and predictors of depersonalization experiences in the german general population. J Nerv Ment Dis 197(7):499–506CrossRefPubMed

17.

Simeon D, Guralnik O, Schmeidler J, Sirof B, Knutelska M (2001) The role of childhood interpersonal trauma in depersonalization disorder. Am J Psychiatry 158(7):1027–1033CrossRefPubMed

18.

Simeon D, Guralnik O, Knutelska M, Schmeidler J (2002) Personality factors associated with dissociation: temperament, defenses, and cognitive schemata. Am J Psychiatry 159(3):489–491CrossRefPubMed

19.

Michal M, Heidenreich T, Engelbach U, Lenz C, Overbeck G, Beutel M, Grabhorn R (2006) Depersonalisation, soziale Ängste und Scham. PPmP-Psychotherapie Psychosomatik Medizinische Psychologie 56:383–389CrossRef

20.

Michal M, Kaufhold J, Grabhorn R, Krakow K, Overbeck G, Heidenreich T (2005) Depersonalization and social anxiety. J Nerv Ment Dis 193(9):629–632 (00005053-200509000-00009)CrossRefPubMed

21.

Wolfradt U, Engelmann S (1999) Depersonalization, fantasies, and coping behavior in clinical context. J Clin Psychol 55(2):225–232CrossRefPubMed

22.

Michal M, Wiltink J, Till Y, Wild PS, Muenzel T, Blankenberg S, Beutel ME (2010) Type-D personality and depersonalization are associated with suicidal ideation in the German general population aged 35–74: results from the Gutenberg Heart Study. J Affect Disord 125(1–3):227–233. doi:10.1016/j.jad.2010.02.108 CrossRefPubMed

23.

Tschan R, Wiltink J, Adler J, Beutel ME, Michal M (2013) Depersonalization experiences are strongly associated with dizziness and vertigo symptoms leading to increased health care consumption in the German general population. J Nerv Ment Dis 201(7):629–635. doi:10.1097/NMD.0b013e3182982995 CrossRefPubMed

24.

Michal M, Beutel ME, Grobe TG (2010) How often is the Depersonalization-Derealization Disorder (ICD-10: F48.1) diagnosed in the outpatient health-care service? Z Psychosom Med Psychother 56(1):74–83PubMed

25.

Aderibigbe YA, Bloch RM, Walker WR (2001) Prevalence of depersonalization and derealization experiences in a rural population. Soc Psychiatry Psychiatr Epidemiol 36(2):63–69CrossRefPubMed

26.

Hurlimann F, Kupferschmid S, Simon AE (2012) Cannabis-induced depersonalization disorder in adolescence. Neuropsychobiology 65(3):141–146. doi:10.1159/000334605 CrossRefPubMed

27.

Simeon D, Knutelska M, Nelson D, Guralnik O (2003) Feeling unreal: a depersonalization disorder update of 117 cases. J Clin Psychiatry 64(9):990–997CrossRefPubMed

28.

Michal M, Zwerenz R, Tschan R, Edinger J, Lichy M, Knebel A, Tuin I, Beutel M (2010) Screening for depersonalization-derealization with two items of the cambridge depersonalization scale. Psychother Psychosom Med Psychol 60(5):175–179. doi:10.1055/s-0029-1224098 CrossRefPubMed

29.

Sierra M, Berrios GE (2000) The Cambridge depersonalization scale: a new instrument for the measurement of depersonalization. Psychiatry Res 93(2):153–164 (pii:S0165178100001001)CrossRefPubMed

30.

Michal M, Sann U, Niebecker M, Lazanowsky C, Kernhof K, Aurich S, Overbeck G, Sierra M, Berrios GE (2004) The measurement of the depersonalisation-derealisation-syndrome with the German version of the Cambridge depersonalisation scale (CDS). Psychother Psychosom Med Psychol 54(9–10):367–374. doi:10.1055/s-2004-828296 CrossRefPubMed

31.

Lowe B, Wahl I, Rose M, Spitzer C, Glaesmer H, Wingenfeld K, Schneider A, Brahler E (2010) A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. J Affect Disord 122(1–2):86–95. doi:10.1016/j.jad.2009.06.019 (S0165-0327(09)00278-X)CrossRefPubMed

32.

Simeon D, Guralnik O, Schmeidler J (2001) Development of a depersonalization severity scale. J Trauma Stress 14(2):341–349. doi:10.1023/A:1011169019614 CrossRefPubMed

33.

Prinz U, Nutzinger DO, Schulz H, Petermann F, Braukhaus C, Andreas S (2013) Comparative psychometric analyses of the SCL-90-R and its short versions in patients with affective disorders. BMC Psychiatry 13:104. doi:10.1186/1471-244x-13-104 CrossRefPubMedCentralPubMed

34.

Schauenburg H, Strack M (1999) Measuring psychotherapeutic change with the symptom checklist SCL 90 R. Psychother Psychosom 68(4):199–206CrossRefPubMed

35.

Werbart A, Forsstrom D, Jeanneau M (2012) Long-term outcomes of psychodynamic residential treatment for severely disturbed young adults: a naturalistic study at a Swedish therapeutic community. Nord J Psychiatry 66(6):367–375. doi:10.3109/08039488.2012.654508 CrossRefPubMed

36.

Carver CS (1997) You want to measure coping but your protocol’s too long: consider the brief COPE. Int J Behav Med 4(1):92–100. doi:10.1207/s15327558ijbm0401_6 CrossRefPubMed

37.

Jerusalem M, Schwarzer R (1981) General self-efficacy scale. Freie Universitat, Berlin, Gesundheitspsychologie 1993:2000

38.

Luszczynska A, Scholz U, Schwarzer R (2005) The general self-efficacy scale: multicultural validation studies. J Psychol 139(5):439–457. doi:10.3200/jrlp.139.5.439-457 CrossRefPubMed

39.

Thiel A, Jacobi C, Horstmann S, Paul T, Nutzinger DO, Schussler G (1997) A German version of the eating disorder inventory EDI-2. Psychother Psychosom Med Psychol 47(9–10):365–376PubMed

40.

Riphahn RT, Schieferdecker F (2012) The transition to tertiary education and parental background over time. J Popul Economics 25(2):635–675CrossRef

41.

Barkmann C, Schulte-Markwort M (2004) Prevalence of emotional and behavioral disorders in children and adolescents in Germany—a systematic literature review. Psychiatr Prax 31(6):278–287. doi:10.1055/s-2003-814855 CrossRefPubMed

42.

Ihle W, Esser G (2002) Epidemiology of mental disorders in childhood and adolescence: prevalence, course, comorbidity and gender differences. Psychol Rundsch 53:159–169CrossRef

43.

Zammit S, Kounali D, Cannon M, David AS, Gunnell D, Heron J, Jones PB, Lewis S, Sullivan S, Wolke D, Lewis G (2013) Psychotic experiences and psychotic disorders at age 18 in relation to psychotic experiences at age 12 in a longitudinal population-based cohort study. Am J Psychiatry 170(7):742–750. doi:10.1176/appi.ajp.2013.12060768 CrossRefPubMed

44.

Aderibigbe YA, Bloch RR, Walker WR (2001) Prevalence of depersonalization and derealization experiences in a rural population. Soc Psychiatry Psychiatr Epidemiol 36(2):63–69CrossRefPubMed

45.

Michal M, Tavlaridou I, Subic-Wrana C, Beutel ME (2012) Fear of going mad—differentiating between neurotic depersonalization-derealization-syndrome and paranoid schizophrenia. Nervenheilkunde 31(12):934–937

46.

Mula M, Pini S, Cassano GB (2007) The neurobiology and clinical significance of depersonalization in mood and anxiety disorders: a critical reappraisal. J Affect Disord 99(1–3):91–99. doi:10.1016/j.jad.2006.08.025 (pii:S0165-0327(06)00360-0)CrossRefPubMed

47.

Tolmunen T, Maaranen P, Hintikka J, Kylma J, Rissanen ML, Honkalampi K, Haukijarvi T, Laukkanen E (2007) Dissociation in a general population of Finnish adolescents. J Nerv Ment Dis 195(7):614–617. doi:10.1097/NMD.0b013e318093f487 CrossRefPubMed

48.

Maaranen P, Tanskanen A, Hintikka J, Honkalampi K, Haatainen K, Koivumaa-Honkanen H, Viinamaki H (2008) The course of dissociation in the general population: a 3-year follow-up study. Compr Psychiatry 49(3):269–274. doi:10.1016/j.comppsych.2007.04.010 (pii:S0010-440X(07)00172-1)CrossRefPubMed

49.

Hölling H, Kurth B-M, Rothenberger A, Becker A, Schlack R (2008) Assessing psychopathological problems of children and adolescents from 3 to 17 years in a nationwide representative sample: results of the German health interview and examination survey for children and adolescents (KiGGS). Eur Child Adolesc Psychiatry 17(1):34–41CrossRefPubMed

50.

Baker D, Hunter E, Lawrence E, Medford N, Patel M, Senior C, Sierra M, Lambert MV, Phillips ML, David AS (2003) Depersonalisation disorder: clinical features of 204 cases. Br J Psychiatry 182:428–433CrossRefPubMed

51.

Richardson LP, Rockhill C, Russo JE, Grossman DC, Richards J, McCarty C, McCauley E, Katon W (2010) Evaluation of the PHQ-2 as a brief screen for detecting major depression among adolescents. Pediatrics 125(5):e1097–e1103. doi:10.1542/peds.2009-2712 CrossRefPubMedCentralPubMed

52.

Michal M, Beutel M, Grobe T (2010) How often is the Depersonalization-Derealization Disorder (ICD-10: F48. 1) diagnosed in the outpatient health-care service? Z Psychosom Med Psychother 56(1):74–83PubMed

53.

Simeon D, Abugel J (2006) Feeling unreal: depersonalization disorder and the loss of the self. Oxford University Press, Oxford

54.

Sierra M (2009) Depersonalization: a new look at a neglected syndrome. Cambridge University Press, CambridgeCrossRef

Titel: Prevalence and correlates of depersonalization in students aged 12–18 years in Germany
verfasst von: Matthias Michal
Eva Duven
Sebastian Giralt
Michael Dreier
Kai W. Müller
Julia Adler
Manfred E. Beutel
Klaus Wölfling
Publikationsdatum: 01.06.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Social Psychiatry and Psychiatric Epidemiology / Ausgabe 6/2015
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-014-0957-2

Neu im Fachgebiet Psychiatrie

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

23.04.2024 Depression antepartal oder postpartal Nachrichten

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2015

Explaining the income and suicidality relationship: income rank is more strongly associated with suicidal thoughts and attempts than income

Help-seeking behaviour following school-based screening for current suicidality among European adolescents

How financial hardship is associated with the onset of mental health problems over time

Why searching for psychosis in diverse settings is important for global research and mental health systems development