Psychedelic-Associated Depersonalization-Derealization Disorder.

Q3 Neuroscience
Matthias Michal
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Abstract

Depersonalization (DP) and Derealization (DR) refer to perceptual changes of "as-if-character" where the self (→DP) or the surroundings (→DR) are experienced as unreal. These symptoms are highly prevalent in individuals with mental disorders. If these symptoms persist most of the day for months, the diagnosis of depersonalization-derealization-disorder (DDD) is likely. DDD is a common disorder with a high comorbidity with depression, anxiety disorders, and personality disorders.The intake of classic psychedelic drugs often elicits DP/DR symptoms, which cease in most cases when the drug is eliminated. DDD is frequently precipitated by drug intoxication (cannabis and classic psychedelics). Patients and some researchers assume, therefore, that drug intoxication is the cause of DDD and frame it as a "never-ending trip." Researchers base their assumption on the potential of psychedelics to elicit DP/DR symptoms and on case series of individuals reporting long-lasting uncomfortable symptoms after drug intake. Arguments are presented that demonstrate this is a reductionist conclusion and that this assertion may lead to false illness perceptions, hinder awareness of emotional conflicts, and erode patients' self-efficacy. The main arguments are that, first, DDD is a mental disorder resulting from the avoidance of aversive emotional states. DDD is related to functional alterations of brain networks rather than organic brain damage. Second, psychedelics act as a catalyst that accelerates the onset of DDD in vulnerable individuals by mobilizing complex anxiety-laden unconscious emotions from early attachment traumas.The treatment of DDD encompasses psychoeducation about the nature of the disorder, challenging false causal attributions to external causes (such as drug intake) and helping the patient experience and process their emotions adaptively. To achieve remission, patients usually need long-term psychotherapy of 50-100 sessions.

迷幻相关的人格解体-现实感丧失障碍。
人格解体(Depersonalization, DP)和现实解体(derealalization, DR)是指“仿佛人物”的感知变化,其中自我(→DP)或周围环境(→DR)被体验为不真实。这些症状在精神障碍患者中非常普遍。如果这些症状持续几个月,诊断为人格解体障碍(DDD)是可能的。DDD是一种常见的疾病,与抑郁症、焦虑症和人格障碍有很高的合并症。经典迷幻药物的摄入通常会引起DP/DR症状,在大多数情况下,当药物被消除后,这些症状就会消失。DDD通常由药物中毒(大麻和经典迷幻药)引起。因此,患者和一些研究人员认为药物中毒是DDD的原因,并将其描述为“永无止境的旅程”。研究人员的假设是基于迷幻药诱发DP/DR症状的可能性,以及在服用迷幻药后报告长期不舒服症状的个体病例系列。提出的论点表明,这是一个简化主义的结论,这种断言可能导致错误的疾病认知,阻碍对情感冲突的认识,并侵蚀患者的自我效能感。主要的论点是,首先,DDD是一种由于回避厌恶情绪状态而导致的精神障碍。DDD与脑网络的功能改变有关,而不是器质性脑损伤。第二,致幻剂作为催化剂,通过调动来自早期依恋创伤的复杂的、充满焦虑的无意识情绪,加速了脆弱个体DDD的发病。DDD的治疗包括对疾病本质的心理教育,挑战对外部原因(如药物摄入)的错误因果归因,并帮助患者适应地体验和处理他们的情绪。为了达到缓解,患者通常需要50-100次的长期心理治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current topics in behavioral neurosciences
Current topics in behavioral neurosciences Neuroscience-Behavioral Neuroscience
CiteScore
4.80
自引率
0.00%
发文量
103
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