Prevalence and childhood antecedents of depersonalization syndrome in a UK birth cohort
Depersonalization syndrome is characterised by a sense of unreality about the self [depersonalization (DP)] and/or the outside world [derealization (DR)]. Prevalence estimates vary widely. Little is known about childhood antecedents of the disorder although emotional abuse is thought to play a role.
Longitudinal data from 3,275 participants of a UK population-based birth cohort (the MRC National Survey of Health and Development) were used to: (1) assess the prevalence of DP syndrome at age 36, measured by the Present State Examination (PSE); and (2) examine the effects of a range of socio-demographic, childhood adversity and emotional responses as potential risk factors for DP.
Thirty three survey members were classified with DP, yielding a prevalence of 0.95% [95% confidence intervals (CI) 0.56–1.34]. There were no associations with socio-economic status, parental death or divorce; self-reported accidents, childhood depression, tendency to daydream or reactions to criticism. However, teacher-estimated childhood anxiety was a strong independent predictor of adult depersonalization, and there were strong cross-sectional relationships between DP and anxiety and depression caseness.
To our knowledge this is the first study assessing nationwide prevalence of the DP syndrome and uses longitudinal data to explore childhood risk factors for adult DP. The prevalence of adult DP was slightly lower than reported by other surveys. The study found that childhood anxiety was the only significant predictor of the adult DP syndrome, supporting the view that depersonalisation disorder forms part of the spectrum of responses to anxiety.
KeywordsDepersonalization Prevalence Population Childhood Anxiety
A.S.D. acknowledges financial support from the Department of Health via the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health award to South London and Maudsley NHS Foundation Trust (SLaM) and the Institute of Psychiatry at King’s College London. W.E.L. is funded by a Medical Research Council Training Fellowship.
- 4.World Health Organization (1992) The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization, GenevaGoogle Scholar
- 5.American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders: DSM-IV, 4th edn. American Psychiatric Association, Washington D.C.Google Scholar
- 22.Simeon D, Abugel J (2006) Feeling unreal: depersonalization disorder and the loss of the self. OUP, New YorkGoogle Scholar
- 23.Schilder P (1914) Selbstbewusstsein und Persönlichkeitsbewusstsein. Monographien aus dem Gesamtgebiete der Neurologie und Psychiatrie., Heft 9. BerlinGoogle Scholar
- 33.CS OP (1971) Office of population censuses and surveys. Classification of occupations 1970. HMSO, LondonGoogle Scholar
- 34.Department of Education and Science (1972) Burnham further education committee grading courses. HMSO, LondonGoogle Scholar
- 36.Wing JK, Cooper JE, Sartorius N (1974) The measurement of classification of psychiatric symptoms. An instruction manual for the PSE and Catego Program. Cambridge University Press, CambridgeGoogle Scholar
- 37.Wing JK, Sturt E (1978) The PSE-ID-CATEGO system: a supplementary manual. Institute of Psychiatry, London (mimeo)Google Scholar
- 39.Wing J, Cooper J, Sartorius N (1974) The measurement and classification of psychiatric symptoms. Cambridge University Press, LondonGoogle Scholar
- 40.World Health Organization (1992) SCAN: schedules for clinical assessment in neuropsychiatry. World Health Organization, GenevaGoogle Scholar
- 43.Ross CA, Heber S, Norton GR, Anderson D, Anderson G, Barchet P (1989) The dissociative disorders interview schedule: a structured interview. Dissociation 2(3):169–189Google Scholar
- 52.Richards M, Abbott R (2009) Childhood mental health and life chances in post-war Britain. http://www.nshd.mrc.ac.uk/pdf/life_chances_report.pdf. Accessed 6th June 2010