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Depersonalisation/derealisation symptoms in vestibular disease
F Yen Pik Sang1, K Jáuregui-Renaud, D A Green
1Department of Movement and Balance, Imperial College, London, UK.
Journal of Neurology, Neurosurgery, and Psychiatry
|February 9, 2006
Summary
Depersonalisation/derealisation symptoms are more frequent and distinct in patients with peripheral vestibular disease. Vestibular stimulation can experimentally induce these feelings of unreality and detachment from self.
Area of Science:
- Neuroscience
- Psychiatry
- Otolaryngology
Background:
- Depersonalisation involves feelings of unreality and self-detachment.
- Derealisation is the perception of the external world as strange or unreal.
- Vestibular stimulation can trigger these dissociative experiences.
Purpose of the Study:
- To determine the prevalence of depersonalisation/derealisation symptoms in peripheral vestibular disease patients.
- To experimentally induce these symptoms using vestibular stimulation.
Main Methods:
- 121 healthy subjects and 50 patients with peripheral vestibular disease completed questionnaires.
- A subgroup of 50 age-matched controls was used for comparison.
- Caloric irrigation was used to experimentally induce symptoms in 20 patients and 20 controls.
Main Results:
- Vestibular patients reported significantly more frequent and severe depersonalisation/derealisation symptoms than controls.
- Patients commonly experienced derealisation symptoms like feeling "spacey" or "not in control of self".
- Caloric stimulation induced symptoms in healthy subjects, which patients recognized as similar to their disease experience.
Conclusions:
- Depersonalisation/derealisation symptoms are qualitatively different and more common with non-physiological vestibular stimulation.
- In vestibular disease, sensory mismatch from distorted vestibular signals may cause derealisation.
- This sensory incoherence can lead to feelings of detachment from the self and the external world.
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