Article

Prevalence of depersonalization and derealization experiences in a rural population

Department of Psychiatric Medicine, Brody 4E-100, East Carolina University School of Medicine, Greenville, NC 27858, USA.
Social Psychiatry and Psychiatric Epidemiology (Impact Factor: 2.58). 03/2001; 36(2):63-9. DOI: 10.1007/s001270050291
Source: PubMed

ABSTRACT Dissociative symptoms are common psychiatric symptoms whose prevalence in rural (agricultural) populations is unknown. The present study examines the prevalence of depersonalization and derealization experiences in a southern rural US population as well as socio-demographic and emotional factors associated with these experiences.
A random sample of 1008 adults in rural eastern North Carolina completed a survey by telephone, which included questions about experiences of depersonalization or derealization in the past year. Demographic information was gathered on all respondents; for those reporting these dissociative experiences, information on their frequency, duration, and whether they occurred during conditions of danger, severe stress, upsetting memories, nervousness or depression, or for no apparent reason was also elicited.
The reported prevalence rates were 19.1% for depersonalization, 14.4% for derealization, and 23.4% for either dissociative experience. Logistic regression showed that women reported a significantly higher rate of dissociative experiences (26.5%) than men (19.5%), (Odds Ratio = 1.93, 95% CI = 1.37-2.74), particularly African-American women (29.9%). Experiencing chronic pain (OR = 2.96, 95% CI = 2.05-4.28) and irregular church attendance (OR = 1.18, 95% CI = 1.07-1.31) were also associated with increased frequency of dissociation. Increasing age (OR = 0.73, 95% CI = 0.65-0.81) and being employed (OR = 0.58, 95% CI = 0.39-0.86) were associated with reduced frequency of dissociation. Pain, gender, and age were related to both depersonalization and derealization experiences. Employment and church attendance were related to depersonalization experiences, while ethnic minorities experienced more derealization.
A predominantly southern rural population reported a high 1-year prevalence of depersonalization and derealization experiences. The prevalence of dissociation experiences was common in this southern sample, as was found by Ross and colleagues (1990) in an urban population in Canada. Risk factors for depersonalization and derealization experiences had considerable overlap, but differed on several variables suggesting different underlying mechanisms.

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    • "DPRD is frequently a chronic disorder, affecting between 1% and 2.4% of the general population with a gender ratio of about 1:1, although its comorbidity with depression and anxiety falls between the percentage ranges of 20–40 (Bebbington et al. 1997; Hunter et al. 2004a; Ross 1991). Depersonalisation and derealisation symptoms seem to be more common among women (26.5%) than men (19.5%) (Aderibigbe et al. 2001). It was estimated in one survey that DPRD occurred in 80% of psychiatric inpatients and that 12% of them suffered from a severe form of this condition (Brauer et al. 1970). "
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    • "The Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR; American Psychiatric Association, 2000) describes depersonalization and derealization as ''an alteration in the perception or experience of the self so that one feels detached from, and as if one is an outside observer of, one's mental processes or body (e.g., feeling as in a dream)'' and ''an alteration in the perception or experience of the external world so that it seems strange or unreal (e.g., people seem unfamiliar)'', respectively. 1 Transient experiences of depersonalization are common in the general population, with a prevalence of about 19% as found in a representative telephone survey that measured the self-reported presence of DSM-IV criteria for DPD/DR during the last 12 months (Aderibigbe et al., 2001). However, when depersonalization becomes persistent or recurrent and is associated with significant distress and/or impairment, a diagnosis of Depersonalization Disorder (DPD) should be considered. "
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    • "The study was based on a survey in a rural population of the United States. In the context of 2 questions posed in a telephone interview, a random sample of n ϭ 1.008 adults provided information on the 1-year prevalence of DP and derealization (Aderibigbe et al., 2001); 19.1% indicated having suffered from DP, 14.4% from derealization , and 23.4% reported having encountered both phenomena. The authors found a significantly higher prevalence for DP and derealization in women (odds ratio ͓OR͔: 1.93, 95% confidence intervals ͓95% CI͔: 2.05– 4.28), in individuals with chronic pain (OR: 2.96, 95% CI: 2.05– 4.28) and in those with irregular church attendance (OR: 1.18, 95% CI: 1.07– 41.31). "
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