Prevalence and correlates of depersonalization in students aged 12–18 years in Germany
- 535 Downloads
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.
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.
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.
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.
KeywordsDepersonalization School Cannabis Smoking Coping General self-efficacy Resilience
This study was supported by the ministry of Social Affairs, Labour, Health and Demography of Rhineland-Palatinate.
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
- 2.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)CrossRefPubMedGoogle Scholar
- 6.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 )CrossRefPubMedGoogle Scholar
- 7.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)CrossRefPubMedGoogle Scholar
- 9.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 CrossRefPubMedGoogle Scholar
- 12.Meyer JE (1962) Reifungskrisen der Adoleszenz, ihre Entstehungsbedingungen und ihre Prognose. Eur Arch Psychiatry Clin Neurosci 203(3):235–247Google Scholar
- 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 CrossRefPubMedGoogle Scholar
- 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 CrossRefPubMedGoogle Scholar
- 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 CrossRefPubMedGoogle Scholar
- 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)CrossRefPubMedGoogle Scholar
- 37.Jerusalem M, Schwarzer R (1981) General self-efficacy scale. Freie Universitat, Berlin, Gesundheitspsychologie 1993:2000Google Scholar
- 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 CrossRefPubMedGoogle Scholar
- 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):934–937Google Scholar
- 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)CrossRefPubMedGoogle Scholar
- 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):34–41CrossRefPubMedGoogle Scholar
- 53.Simeon D, Abugel J (2006) Feeling unreal: depersonalization disorder and the loss of the self. Oxford University Press, OxfordGoogle Scholar