Episodic Depersonalization

Abstract

The constellation of symptoms which is termed depersonalization is often as perplexing to the doctor as to the patient. It is more easily diagnosed than defined, and much of the controversy over its nosological position can be attributed to this vagueness of outline. Saperstein (1949) reviewed the historical development of the concept and concluded that the essential feature is the experience of a sense of strangeness or unreality to the individual of his personality, his body or the external environment. Other symptoms of cerebral dysfunction, such as perceptual distortion of the body image, déjà vu experiences, olfactory and auditory hallucinations, metamorphopsia, autoscopy and a disordered time sense, are frequently, but not necessarily, associated (Antoni, 1946; Roth, 1959). The difficulty of expressing unusual subjective events in words gives rise to descriptions remarkable for their rich and often bizarre metaphor (e.g. Lewis, 1934; Bockner, 1949; Roth, 1959). Saperstein (1949) and Bird (1958) emphasize the “as if” qualification of these accounts, which distinguishes them from the delusional experiences of depression and schizophrenia.