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The cerebral mechanisms of traits associated with depersonalization-derealization disorder (DPRD) remain poorly understood.
Happy and sad emotion expressions were presented to DPRD and non-referred control (NC) subjects in an implicit event-related functional magnetic resonance imaging (fMRI) design, and correlated with self report scales reflecting typical co-morbidities of DPRD: depression, dissociation, anxiety, somatization.
Significant differences between the slopes of the two groups were observed for somatization in the right temporal operculum (happy) and ventral striatum, bilaterally (sad). Discriminative regions for symptoms of depression were the right pulvinar (happy) and left amygdala (sad). For dissociation, discriminative regions were the left mesial inferior temporal gyrus (happy) and left supramarginal gyrus (sad). For state anxiety, discriminative regions were the left inferior frontal gyrus (happy) and parahippocampal gyrus (sad). For trait anxiety, discriminative regions were the right caudate head (happy) and left superior temporal gyrus (sad).
The ascertained brain regions are in line with previous findings for the respective traits. The findings suggest separate brain systems for each trait.
Our results do not justify any bias for a certain nosological category in DPRD.
Depersonalization is a dissociative disorder, causing alteration in the perception or experience of the self and a detachment from reality. This is a fascinating and clinically relevant phenomenon neglected within psychiatry. Far from being a rare condition, it can be as prevalent as schizophrenia or bipolar disorder and frequently occurs in association with other neuropsychiatric conditions. This book is a review of depersonalization, dealing with the subject from a wide range of perspectives and covering historical, conceptual, clinical, trans-cultural, pharmacological and neurobiological factors. It discusses recent neuroimaging studies providing fresh insights into the condition and opening up new opportunities to manage the symptoms with pharmacologic and psychotherapeutic interventions. It will be relevant to psychiatrists and clinical psychologists, as well as primary care practitioners, neurologists and psychiatric nurses.