Depersonalisation Disorder Flashcards
What is the DSM-5 definition of depersonlisation?
Feeling of detachment from the body/cognitively or from themselves/environment
What percentage of the population does DPD affect?
1%
What is the causal model for DPD?
from normally protective neural response to high levels of arousal (panic/life threatening) becomes persistent and dysfunctional
What is the mean age of onset
22.8 years
What are the causal attributions of DPD?
Psychological (15%), traumatic event (14%), substance misuse (cannabis, 14%), multiple (20%), none obvious (27%)
What factors worsen DPD symptoms?
Psychological stress, environmental lighting, physical stressors (fatigue)
What happens in DPD (psychophysiology)?
abnormal CV sympathetic and parasympathetic responses to physical and emotional stimuli
What does fMRI show for DPD?
increased prefrontal cortex and decreased limbic activation to emotionally arousing stimuli (may underlie emotional detachment)
What is there a reciprocal relationship between?
anterior insula and VLPFC (increased activation)
Where are the grey matter changes in?
frontal, temporal and parietal lobes
What is visual hypoemotionality?
inability to endow visual perception with emotional feelings
What is Asomatognosia?
Missing feeling of body parts
What did cognitive studies show?
empathy performance is unimpaired despite subjective deficits, normal effects of overt emotion on memory and less sensitive to negative facial expressions of emotion
What are the treatments used in DPD?
Lamotrigene add on to SSRIs
Repetitive transcranial magnetic stimulation
Biofeedback
How does lamotrigene work in DPD?
glutamate antagonist that blocks ketamine induced DPD/derealisation
