[Depersonalization-derealization in the psychosomatic outpatient and consultation-liaison service].
OBJECTIVE
First, to determine the prevalence of symptoms of depersonalization (DP) and derealization (DR) in psychosomatic consultation-liaison patients and psychosomatic outpatients; second, to examine how DP-DR contributes to differences among patients with respect to the spectrum of other diagnoses, disease severity, history of psychotherapeutic outpatient treatment and psychiatric/psychosomatic inpatient treatments as well as to self-rated distress.


METHODS
The sample comprises n=825 patients. In order to analyze the effects of DP-DR, the sample was divided into three subgroups of DP-DR severity: patients without symptoms of DP-DR, patients with mild DP-DR, and patients with clinical significant DP-DR.


RESULTS
34.8% patients had no symptoms of DP-DR, 48.2% mild DP-DR, and 17.0% scored clinical significant DP-DR. The severity of DP-DR was associated with other indicators of self- and observer-rated disease severity as well as with greater psychosomatic and psychiatric health care use. However, after adjustment for indicators of disease severity, the significant association between the use of psychotherapeutic outpatient treatment and psychiatric or psychosomatic inpatient treatment in the medical history disappeared.


CONCLUSIONS
Symptoms of DP-DR are very common in psychosomatic patients. They represent an indicator of disease severity, which however is paradoxically not associated with increased use of psychotherapeutic health care.
Michal
Matthias
M
Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz. michal@psychosomatik.klinik.uni-mainz.de
Wiltink
Jörg
J
Zwerenz
Rüdiger
R
Knebel
Achim
A
Schäfer
Anke
A
Nehring
Cornelia
C
Subic-Wrana
Claudia
C
Beutel
Manfred E
ME
D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003861:Depersonalization / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005858:Germany; D006760:Hospitalization / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010555:Personality Inventory; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011613:Psychotherapy / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014600:Utilization Review