Symptom profile and diagnostic utility of depersonalization–derealization disorder: A retrospective critical review from India

Background: Depersonalization and derealization (DPDR) syndrome results from complex interwoven sensory motor experiences seen across psychiatric disorders. There is sparse literature from India on DPDR symptoms, their clinical and research utility. This study focuses frequency of coding the diagnosis of DPDR (ICD-10) and critical discussion about its clinical and research utility. Methods: A retrospective review of case files coded under ICD code F48.1 was carried out for 10 years and details were systematically analyzed for age, gender, duration, phenomenology, comorbid diagnosis, and pharmacological treatment. Results: Fourteen patients received the diagnosis of DPDR. Mean duration of DPDR syndrome was 6 years (standard deviation [SD] = 2.2) while mean age of presentation to hospital was 24 years (SD = 2.5). Tactile imagery (50%), self-environmental integration (42%), and dream-reality integration (28%) were the major themes. Selective serotonin reuptake inhibitors were used as primary medication for 65% of patients. Conclusion: Isolated DPDR syndrome has been diagnosed very rarely in recent past. Reasons may include ignoring the comorbid DPDR coding, inability to articulate DPDR symptoms, inadequate documentation and misinterpretation of symptoms or actually less prevalence of DPDR syndrome in India. Considering scanty literature on DPDR as a primary diagnosis, more studies are required to identify the actual prevalence and coding of DPDR in future.