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A 20-Year Descriptive Phenomenological Study of Depersonalization and Derealization as an Alteration in Sense of Self and Lifeworld.

Cherise Rosen, Liping Tong, Julia G. Lebovitz, Sohee Park, Clara Humpston

Schizophrenia Bulletin April 10, 2026 DOI: 10.1093/schbul/sbag013 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Prospective longitudinal study Peer reviewed
Population Psychiatric patients across diagnostic categories
Duration 20 years
Topics Philosophy of mind Ego dissolution
Keywords Depersonalization Derealization Psychosis Schizophrenia Self-disturbance
Key findings Depersonalization is broadly distributed across diagnostic categories, while derealization shows greater specificity to schizophrenia; self-disturbance is a foundational construct in schizophrenia but not in affective psychosis.

Abstract

Depersonalization (DP) and derealization (DR) are phenomena involving alterations in sense of self and lifeworld. These phenomena often co-occur in psychosis, suggesting dimensional psychopathology and complex phenomenological alterations in consciousness, embodiment, and meaning-making. The primary aim of this study was to examine phenomenological associations, dynamics, and diagnostic representations of DP and DR across psychiatric categories over 20 years. The Chicago Longitudinal Study is a prospective study designed to investigate psychopathology, psychosocial determinants, and recovery. Primary clinical indices were DP and DR as measures of alterations in sense of self and lifeworld. DP and DR are transdiagnostic yet more prevalent in schizophrenia. DP was broadly distributed across diagnostic categories and DR showed greater specificity to schizophrenia. Multiple linear regressions of DP and DR revealed specific points of convergence and divergence in positive and negative symptoms. Network analyses revealed three foundational constructs: alteration in sense of self/lifeworld, multisensory, and bodily experiences in schizophrenia, with bodily and multisensory alterations foundational in affective-psychosis. Notably, self-disturbance emerged as a foundational construct in schizophrenia and not affective psychosis. Whereas alteration in bodily and multisensory experiences emerged as foundational constructs that transcend diagnostic categories. Together, our findings support a reframing of DP and DR, as points on a continuum of attenuated alterations in the sense of self (DP) and lifeworld (DR), introducing a more nuanced and dynamic understanding of these phenomena as a fundamental self-disturbance in the "ontological dimension" or "existential feeling" that constitutes an atmosphere of alternative reality in self-disturbance.

Comparable studies

Other observational and cohort studies on philosophy of mind, most cited first.

Study Year Design Participants
The phenomenology of near-death experiences Subjects who reported near-death experiences 1980 Retrospective study n = 78
Visual Phenomenology of the LSD Flashback Persons with a history of LSD use 1983 Observational cohort n = 123
The neurophenomenology of neutral hypnosis. Individuals of high, medium, and low hypnotizability 2013 Observational cohort n = 37
The Phenomenology of Acute Organic Psychosis Patients with acute organic psychosis and acute schizophrenics 1987 Observational cohort n = 148
EEG oscillatory states as neuro-phenomenology of consciousness as revealed from patients in vegetative and minimally conscious states. Brain-damaged patients with disorders of consciousness and healthy-conscious subjects 2012 Observational cohort

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Philosophy of mind Ego dissolution Altered states of consciousness