مسخ شخصیت: فیزیولوژیک یا آسیب شناختی در نوجوانان؟

Backgorund This study analyzed the presence of DP symptoms in a sample of both psychiatric patients and normal subjects, addressing the issue of DP symptoms in adolescence. Methods A total of 267 subjects (149 patients and 118 healthy controls) aged between 14 and 65 years, were assessed by means of CDS, the SCID-I and the K-SADS. The sample was then divided into two subsamples with a cut-off age of 21 years. Results As expected CDS score was significantly higher in the patient group compared to the healthy control group. As for the age issue, among patients no statistical difference was found comparing subjects over and under 21 years, whereas in the sample of healthy controls, subjects under 21 years reported CDS scores significantly higher. Conclusions While in adults DP symptoms are frequently associated with mental disorders, in adolescents they could be considered as a quasi-physiological phenomenon.

Depersonalization (DP), for long a complex and obscure subject of clinical psychiatry, has become a recurrent topic of psychopathology in the last 10 years [9], [21], [26], [15], [13], [29], [3], [8], [10], [12] and [19]. It is characterized by persistent or recurrent episodes of detachment from one's self: individuals may feel like an automaton or they may have a sensation of estrangement from their own mental processes, emotions or body shape [2]. Often accompanied by derealization (DR), a threatening sense of unreality from the environment, DP can assume various nuanced forms in clinical practice. It occurs on a continuum ranging from transient episodes in healthy people to a significant complex of symptoms—in other psychiatric illnesses, or as a primary mental disorder [11] and [26]. Current epidemiological data show a prevalence of clinically significant DP/DR of approximately 1%–2% in the general population, similar to the prevalence of common mental disorders such as bipolar disorder and obsessive–compulsive disorder [14]. The first systematic epidemiological review shows that the transient symptoms of DP in the general population have a lifetime prevalence ranging between 26% and 74% [9]. To date DP has mostly been investigated in adults but it is emerging as a transient or recurrent experience in youth where it appears to be a puzzling and perhaps consequential phenomenon about which little is still known. The evidence that the onset of DP is in adolescence [25] and [28] leads us to focus on this period when subjects complain about many physical and mental changes. It should be noted that the majority of these complaints are stated in terms of experiences of alienation or unreality that are usually prevalent in DP. In this paper we explore DP in adolescence. Its aim is to compare DP symptoms in adolescents with those in adults, first in patients suffering from mental disorders and then in healthy individuals.