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Cognitive Behavior Therapy for Depersonalization-Derealization Disorder (CBT-f-DDD): a feasibility randomized trial.

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Summary

Cognitive Behavioral Therapy adapted for Depersonalization-Derealization Disorder (CBT-f-DDD) shows promise. This feasibility study indicates CBT-f-DDD is a viable treatment option, though study design refinements are needed for future trials.

Keywords:
CBTDepersonalizationDerealizationFeasibilityRCT

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Mental Health Research

Background:

  • Depersonalization-derealization disorder (DDD) involves persistent feelings of unreality concerning the self or environment.
  • Cognitive Behavioral Therapy adapted for DDD (CBT-f-DDD) has demonstrated effectiveness in clinical audits.
  • This study aimed to assess the feasibility and acceptability of CBT-f-DDD.

Purpose of the Study:

  • To evaluate the feasibility and acceptability of CBT-f-DDD for adult participants with DDD.
  • To gather preliminary data on the effectiveness and health economics of CBT-f-DDD.
  • To inform the design of a future definitive randomized controlled trial (RCT).

Main Methods:

  • An individually randomized design comparing CBT-f-DDD to Treatment as Usual (TAU) in adult DDD patients.
  • CBT-f-DDD was delivered by trained therapists over six months.
  • Feasibility objectives included recruitment, retention, resource use, representativeness, acceptability, preliminary response, and health economics. Qualitative interviews were conducted.

Main Results:

  • Thirty participants were recruited over 13 months; 63% completed the final assessment, indicating a need for improved retention.
  • The study design and intervention were rated as acceptable, with positive qualitative feedback from participants and clinicians.
  • The CBT-f-DDD group showed a greater mean decrease in depersonalization scores (16.9 points) compared to the TAU group (5.5 points). Health economics analysis indicated cost savings and improved Quality-Adjusted Life Years.

Conclusions:

  • CBT-f-DDD is a feasible treatment for Depersonalization-Derealization Disorder.
  • The study provides a foundation for a larger, definitive RCT of CBT-f-DDD.
  • Refinements in study design and intervention delivery are recommended for future research.