![]() ![]() Symptoms belonging to category (a) can, for instance, occur in affective disorders of almost psychotic depth, due to a pathologically changed self-esteem. In my view, this scheme is useful and corresponds to clinical realities. Category (b), in their scheme, refers to altered bodily sensations: "the body part of the self" (Are there any body parts of the self? Perhaps all psychoanalysts would not agree). Category (a), which come closest to depersonalization, includes experiences related to the self, whereas category (c) refers to impressions that the external world is unreal. ![]() The authors present a useful scheme by which different meanings of derealization are separated and that also points out the differences between depersonalization and derealization, although they are mutually dependant. The border between unreality feelings with largely intact reality-testing ability and psychotic disorders with grossly disturbed reality-testing is, however, not absolute and patients with psychotic disorders may of course experience feelings of unreality or depersonalization There is at least one clear agreement in the different diagnostic systems: psychotic, delusional experiences are excluded. I agree with the authors that the rather intense renewing of the diagnostic criteria is seldom balanced by corresponding ambitions to analyze and improve the distinctness of the words for the experiences and symptoms which define the diagnoses.It is indeed a difficult task to demarcate what should be included in the concepts feelings of unreality and depersonalization and even to decide whether they are synonyms or distinguishable. The latter occurs as a symptom in connection to some psychiatric disorder and also constitutes a separate syndrome Hence the paper by Radovic and Radovic deals with an important topic, aiming to clarify the variety of meanings of the closely related terms unreality and depersonalization. This is critical not only for understanding and offering proper treatment, but also for developing diagnostic classifications. Significant Symptoms With a Variety of Meanings Kjell ModighĮvaluations and diagnostic procedures in clinical psychiatry depend mainly on how the patient communicates his or her subjective experiences and on the psychiatrist's ability to understand that message. ![]() Depersonalization and Feelings of Unreality: In lieu of an abstract, here is a brief excerpt of the content: ![]()
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