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Depersonalization and Derealization Diagnostic Criteria Update DSM-V

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I am very pleased to announce that our research has now been recognized in publications and by the American Psychiatric Association DSM-V Task Force as contributing to the proposed revision of the previously clinically vague criteria of Depersonalization Disorder.

Research manuscripts and textbooks have cited our research 18 times, including supporting the primary citation on DSM5.org.

The proposed change:

Updated May-20-2010

Depersonalization/Derealization Disorder


Either (1), (2), or both:

A1. Depersonalization: Persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one’s mental processes or body (e.g., feeling as though one is in a dream; sense of unreality of self or body; or time moving slowly)

A2. Derealization: Persistent or recurrent experiences of unreality of surroundings (e.g., world around the person is experienced as unreal, dreamlike, distant, or distorted)

B. During the depersonalization or derealization experience, reality testing remains intact 

C. The depersonalization or derealization symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

D. The depersonalization or derealization symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., complex partial seizures).

E. The depersonalization or derealization symptoms are not restricted to the symptoms of another mental disorder (e.g.,schizophrenia, panic disorder, acute stress disorder, posttraumatic stress disorder, major depressive disorder, or another dissociative disorder).


Specify if: 

     a) Depersonalization only

     B) Derealization only


The listed rationale for change:

Updated February-14-2011

D and E: Changes allow comorbid diagnoses to be made when warranted.

Reference: Spiegel D et al. (Depression & Anxiety; in preparation)

The group also proposes that depersonalization disorder should retain its classification as a dissociative disorder in its current form. However, it is problematic that chronic derealization is not included in the diagnosis.  In the DSM-IV-TR derealization is classified with DDNOS, which is not in line with the ICD which has depersonalization-derealization as a single disorder.  There is recent empirical evidence that individuals with prominent derealization alone do not significantly differ from those with depersonalization accompanied with derealization in any respect, including demographics, precipitants, illness characteristics, and comorbidity (Simeon 2009) 

Simeon D. 2009. Depersonalization disorder. In: Dell PF, O'Neil JA, editors. Dissociation and dissociative disorders: DSM-V and beyond. New York: Routledge. 2009. p 441-442.

Congratulations to our collegues in this field and the tremendous advocacy of the International Society for the Study of Trauma and Dissociation. The largest thanks to Dr. Daphne Simeon for her work and expertise on the project and the members who participated in our research.

This revision was posted today.



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  • 8 years later...

My main problem is derealization that creeps up on me. Someone could say something to me or i will hear something that feels too "related" to the trip that messed me up and trigger an episode. I still know who I am during the episodes which I assume means depersonilization is nonexistence in ny case.

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