Depersonalization-derealization symptom complex in the clinic of manifest forms of schizophrenia

Background. The issues of early diagnostics and prevention of schizophrenia, despite more than a century of their study, remain relevant. In recent decades, there has been an increase in interest in the study of depersonalization-derealization symptom complex in the context of verification of the initial manifestations of the disease. Meanwhile, ICD-10 does not include symptoms of depersonalization and derealization in the rank of diagnostically important symptoms for this pathology, and they are traditionally considered as manifestations of schizotypal disorders. The existing contradictions suggest the need for further study of depersonalization and derealization in the clinic of manifest forms of schizophrenia.

The aim of the study. To assess the prevalence and clinical manifestations of depersonalization-derealization in paroxysmal forms of schizophrenia.

Materials and methods. The study included 40 patients with depersonalization-derealization symptoms in the clinical picture of manifest forms of schizophrenia. Typological groups were represented by paranoid schizophrenia with an attack-like or continuous course (18 people) and schizoaffective disorder (22 people). We used such research methods as clinical follow-up, clinical and anamnestic, clinical and psychopathological, and also the Cambridge Depersonalization Scale.

Results. Manifestations of depersonalization-derealization at the pre-manifest stage of the disease were observed in 82.5 % of the study cohort. In most cases, mild and moderate severity was detected – in 37.5 and 42.5 %, respectively; severe form was found only in 20 % of patients. In 17.5 % of cases, manifestations of depersonalization and derealization were periodic, and in the majority (65 %) of patients they were persistent. Almost 1/3 of patients had total depersonalization, 22.5 % had only autopsychic and allopsychic depersonalization, and 17.5 % of cases had isolated somatopsychic depersonalization. An association was found between the severity of depersonalization-derealization and paranoid syndrome. During the disease, as negative disorders increase, the manifestations of depersonalization-derealization are reduced.

Conclusion. The obtained data demonstrate the need for further studying depersonalization symptom complex in the clinic of manifest forms of schizophrenia in the aspect of prognosis of the clinical course of the disease.

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