![]() ![]() 20 The present study attempts to identify the prevalence of depersonalisation/derealisation experiences in vestibular patients in comparison with a control population of healthy subjects. 19 However, reports of depersonalisation/derealisation symptoms in patients with vestibular disease are scarce. 18 Even after head trauma, depersonalisation syndrome has been associated with the feature of vertigo. 14 This tendency for abnormal vestibular stimulation to provoke feelings of unreality has also been found in normal healthy subjects undergoing calorics 15, 16, 17 furthermore, false perceptions of orientation may be a consequence of vestibular disorders. The relationship between vestibular function and feelings of unreality was recognised decades ago, when Schilder emphasised its connection with depersonalisation. ![]() 11 A functional imaging study of patients with depersonalisation disorder has suggested abnormalities in the sensory cortex and areas responsible for an integrated body schema, specifically area 7B, consistent with the proposal that the inferior parietal cortex is concerned with spatial orientation, visuomotor, and vestibular function. 10 Recent studies suggest that unambiguous self location and egocentric visuospatial perspective are related to neural activity at the temporoparietal junction. 8, 9 Of pertinence, Blanke et al propose that autoscopic phenomena (seeing one's body in extra personal space) in epilepsy tend to occur when there is coexisting vestibular dysfunction. 6ĭepersonalisation/derealisation symptoms are also commonly described accompanying a wide variety of psychiatric and neurological disorders, 3, 7 including epilepsy. 6 On the other hand, in consecutive psychiatric inpatient admissions with a mixture of diagnoses, prevalence of depersonalisation/derealisation symptoms in USA, UK, and Canada has varied from 1% to 86%. 5 In USA and UK, student samples, using a variety of data collection methods and diagnostic criteria, prevalence of depersonalisation/derealisation symptoms has been reported as varying from 8.5% to 73.9%. 3, 4 A community questionnaire survey study in the USA has reported prevalence rates of 19.1% for depersonalisation, 14.4% for derealisation, and 23.4% for either dissociative experience. 2 Depersonalisation is often accompanied by derealisation the experience of the external world appearing strange or unreal viewed by some as a distinct disorder or as a subset of depersonalisation. Altered perceptions of the self and the environment are termed “dissociation phenomena” 1 and include depersonalisation which is a subjective experience of unreality and detachment from the self.
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