Symptoms of depersonalization/derealization are independent risk factors for the development or persistence of psychological distress in the general population: Results from the Gutenberg health study

• Published in: Journal of affective disorders 2020-08, Vol.273, p.41-47
• Main Authors: Schlax, Jasmin, Wiltink, Jörg, Beutel, Manfred E., Münzel, Thomas, Pfeiffer, Norbert, Wild, Philipp, Blettner, Maria, Ghaemi Kerahrodi, Jasmin, Michal, Matthias
• Format: Article
• Language: English
• Subjects: Anxiety; Anxiety - epidemiology; Anxiety Disorders - epidemiology; Depersonalization; Depersonalization - epidemiology; Depression; Derealization; Humans; Psychological Distress; Risk Factors
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2020.04.018

•Symptoms of depersonalization are independently associated with the persistence or occurrence of depression/anxiety.•The effect is also independent from a medical history of depression/anxiety.•The effect is independent from sociodemographic factors. Symptoms of depersonalization (DP) and derealization (DR) have a high prevalence in patient and community samples. Previous studies suggested that DP/DR symptoms might represent a marker of disease severity and poor prognosis. However, population-based studies investigating the impact of DP/DR symptoms on the course of depression and anxiety are sparse. Therefore, we aimed to analyze whether symptoms of DP/DR are longitudinally associated with the persistence or incidence of elevated symptoms of depression/anxiety. We analyzed observational data from a sample of 13.182 participants of the Gutenberg Health Study. The outcomes were elevated symptoms of depression/anxiety at the 2.5 years follow-up as determined by the 2-item depression scale (PHQ-2), the 2-item anxiety scale (GAD-2), and the compound measure PHQ-4 respectively. The predictor was the 2-item Cambridge Depersonalization Scale (CDS-2). 8.7% of the sample were bothered by symptoms of DP/DR at baseline. They had an increased risk for elevated symptoms of depression/anxiety at the 2.5-year follow-up beyond baseline depression/anxiety and other factors. Each point increment in the CDS-2 scale, ranging from 0-6, was associated with a 21% increase of risk for PHQ-4 ≥ 3 at the follow-up (odds ratio 1.21, 95% confidence interval 1.11-1.32). The study was mostly questionnaire-based. Symptoms of DP/DR are independent risk factors for the persistence or incidence of elevated symptoms of depression/anxiety. Symptoms of DP/DR represent an easily assessable risk factor for the course of mental disorders. Treatment and prevention of mental disorders might benefit from the broader recognition of these phenomena.