跳到主要内容

DPDR

DPDR（Depersonalization-Derealization Disorder）是一种以持续或反复的自我疏离感和现实感丧失为特征的心理障碍。本分类收录DPDR相关的综述研究、神经影像学发现及临床评估工具开发等核心文献。

文献列表​

作者: Woźniak M.; McEllin L.; Hohwy J.; Ciaunica A.
年份:
DOI: 无
原文链接: https://doi.org/10.1037/xhp0001153
PubMed: 无

摘要（中文）: 暂无摘要

摘要（英文）: 暂无摘要

一句话概括: DPDR患者对身体自我的优先级处理受损，但不影响抽象自我相关信息。

[2] Dpdr 自我与现实感任务电池框架图​

作者: OpenClaw; Zheng S.
年份:
DOI: 无
原文链接: 本地文档
PubMed: 无

摘要（中文）: 围绕 DPDR 构建自我与现实感任务电池的框架文档，提出五大核心测量域及任务-指标-多模态联动的总体结构。

摘要（英文）: 围绕 DPDR 构建自我与现实感任务电池的框架文档，提出五大核心测量域及任务-指标-多模态联动的总体结构。

一句话概括: 提出DPDR自我与现实感测量的五大核心域及任务电池框架。

[3] Dpdr任务文献清单：自我真实感与环境真实感任务​

作者: OpenClaw; Zheng S.
年份:
DOI: 无
原文链接: 本地文档
PubMed: 无

摘要（中文）: 关于 DPDR 中自我真实感、环境真实感、自我—环境边界与相关任务范式的文献整理与评述，服务于后续任务平台设计。

摘要（英文）: 关于 DPDR 中自我真实感、环境真实感、自我—环境边界与相关任务范式的文献整理与评述，服务于后续任务平台设计。

一句话概括: 系统整理DPDR自我真实感与环境真实感任务范式文献。

作者: Murphy R.
年份: 2023
DOI: 无
原文链接: 无
PubMed: 无

摘要（中文）: 本综述系统梳理了DPDR的结构和功能性脑改变及其异质性表现。DPDR不仅涉及多种感觉整合的扰乱，还涉及多个大规模脑网络。虽然目前尚无DPDR的完整解药，但全面了解其神经生物学机制可能有助于开发新型药物和针对性心理干预。

摘要（英文）: Depersonalization and derealization refer to an estranged state of mind that involves a profound feeling of detachment from one's sense of self and the surrounding environment, respectively. The phenomena co-occur on a continuum of severity, ranging from a transient experience as a normal reaction to a traumatic event to a highly debilitating condition with persistent symptoms, formally described as depersonalization/derealization disorder (DPDR). Lack of awareness of DPDR is partly due to a limited neurobiological framework, and there remains a significant risk of misdiagnosis in clinical practice. Earlier literature has focused on several brain regions involved in the experience of depersonalization and derealization, including adaptive responses to stress via defense cascades comprising autonomic functioning, the hypothalamic-pituitary-adrenal (HPA) axis, and various other neurocircuits. Recent evidence has also demonstrated the role of more complex mechanisms that are bolstered by dissociative features, such as emotional dysregulation and disintegration of the body schema. This review intends to abridge the prevailing knowledge regarding structural and functional brain alterations associated with DPDR with that of its heterogenic manifestations. DPDR is not merely the disruption of various sensory integrations, but also of several large-scale brain networks. Although a comprehensive antidote is not available for DPDR, a holistic route to the neurobiological context in DPDR may improve general understanding of the disorder and help afflicted individuals re-establish their sense of personal identity. Such information may also be useful in the development of novel pharmacological agents and targeted psychological interventions.

一句话概括: DPDR涉及多个大规模脑网络的功能与结构改变，亟需深入神经生物学研究。

[5] Unraveling the brain dynamics of depersonalization-derealization disorder: A dynamic functional network connectivity analysis.​

作者: Zheng S.; Zhang F.; Shum H.; Zhang H.; Song N.; Song M.; Jia H.
年份: 2024
DOI: 10.1186/s12888-024-06096-1
原文链接: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-06096-1
PubMed: [https://pubmed.ncbi.nlm.nih.gov/?term=10.1186/s12888-024-06096-1](https://pubmed.ncbi.nlm.nih.gov/?term = 10.1186/s12888-024-06096-1)

摘要（中文）: 本研究招募84名右利手DPD患者和67名健康对照，通过静息态功能磁共振和动态功能网络连接分析，探索DPD的脑动态特征。研究发现DPD患者在额顶网络、感觉运动网络和默认模式网络中存在特定脑网络改变，且tDCS干预可显著改变部分脑状态。

摘要（英文）: BACKGROUND: Depersonalization-Derealization Disorder (DPD), a prevalent psychiatric disorder, fundamentally disrupts self-consciousness and could significantly impact the quality of life of those affected. While existing research has provided foundational insights for this disorder, the limited exploration of brain dynamics in DPD hinders a deeper understanding of its mechanisms. It restricts the advancement of diagnosis and treatment strategies. To address this, our study aimed to explore the brain dynamics of DPD. METHODS: In our study, we recruited 84 right-handed DPD patients and 67 healthy controls (HCs), assessing them using the Cambridge Depersonalization Scale and a subliminal self-face recognition task. We also conducted a Transcranial Direct Current Stimulation (tDCS) intervention to understand its effect on brain dynamics, evidenced by Functional Magnetic Resonance Imaging (fMRI) scans. Our data preprocessing and analysis employed techniques such as Independent Component Analysis (ICA) and Dynamic Functional Network Connectivity (dFNC) to establish a comprehensive disease atlas for DPD. We compared the brain's dynamic states between DPDs and HCs using ANACOVA tests, assessed correlations with patient experiences and symptomatology through Spearman correlation analysis, and examined the tDCS effect via paired t-tests. RESULTS: We identified distinct brain networks corresponding to the Frontoparietal Network (FPN), the Sensorimotor Network (SMN), and the Default Mode Network (DMN) in DPD using group Independent Component Analysis (ICA). Additionally, we discovered four distinct dFNC states, with State-1 displaying significant differences between DPD and HC groups (F = 4.10, P = 0.045). Correlation analysis revealed negative associations between the dwell time of State-2 and various clinical assessment factors. Post-tDCS analysis showed a significant change in the mean dwell time for State-2 in responders (t-stat...

一句话概括: DPD患者存在动态脑网络状态异常，tDCS干预可调节脑动态变化。

[6] White matter abnormalities in first-episode patients with depersonalization/derealization disorder: A tract-based spatial statistics study.​

作者: Ning Y.; Song N.; Zhu H.; Zheng S.; Jia Y.; Yin D.; Li K.; Jia H.
年份: 2022
DOI: 10.1016/j.jad.2022.04.127
原文链接: https://linkinghub.elsevier.com/retrieve/pii/S0165032722004712
PubMed: [https://pubmed.ncbi.nlm.nih.gov/?term=10.1016/j.jad.2022.04.127](https://pubmed.ncbi.nlm.nih.gov/?term = 10.1016/j.jad.2022.04.127)

摘要（中文）: 本研究首次探讨未用药首发DPD患者的白质微结构异常。DPD患者右侧胼胝体和后冠状辐射FA值升高，且与症状严重程度和认知损害相关，提示白质完整性异常可作为DPD潜在生物标志物。

摘要（英文）: BACKGROUND: Neuroimaging studies on depersonalization / derealization disorder (DPD) have revealed that there are structural and functional alterations across numerous brain regions. However, to date, the exact white matter abnormalities that are associated with different clinical symptoms and cognitive impairments in first-episode, drug-naive patients with DPD remain unclear. METHODS: Overall, 25 first-episode, drug-naive patients with DPD and 23 healthy controls were recruited and underwent DTI scans. The tract-based spatial statistics analysis was conducted in order to determine white matter microstructural changes between the two groups. Correlation analysis was conducted between the fractional anisotropy (FA) of abnormal WM fibers and the total score of the 30-item Cambridge Depersonalization Scale (CDS-30), cognitive assessments. RESULTS: Patients with DPD demonstrated higher FA in the right corpus callosum (CC), and posterior corona radiate (CR), compared to healthy controls. The FA in the right CC demonstrated a positive correlation with total score of CDS-30, numbing, unreality of self, perceptual alterations, and temporal disintegration, respectively. FA in the right CR region indicated a positive correlation with the total score of CDS-30, unreality of self, perceptual alterations, and temporal disintegration, respectively. Furthermore, FA in the right CR region was found to be negatively correlated with the Continuous Performance Test and the Stroop color-word test. CONCLUSION: The altered white matter microstructure and cognitive impairments of medication naive DPD patients were observed. Abnormalities in the integrity of CC and CR were associated with severity of symptoms and cognitive impairments, which may provide a potential biomarker for clinical studies on DPD.

一句话概括: 首发未用药DPD患者白质异常，胼胝体及后冠状辐射改变与症状相关。

作者: Jia Y.; Song N.; Ning Y.; Zhu H.; Dong L.; Feng S.; Jia H.; Song M.; Zheng S.
年份: 2025
DOI: 10.1002/brb3.70314
原文链接: https://onlinelibrary.wiley.com/doi/10.1002/brb3.70314
PubMed: [https://pubmed.ncbi.nlm.nih.gov/?term=10.1002/brb3.70314](https://pubmed.ncbi.nlm.nih.gov/?term = 10.1002/brb3.70314)

摘要（中文）: 本研究利用静息态功能磁共振探索DPD患者自我参照加工相关脑区的拓扑和网络特性改变。DPD患者在自我参照网络中表现出显著的连接改变，机器学习分类模型准确率达88.5%，AUC为0.928，提示皮层中线结构和岛叶改变可能与DPD机制相关。

摘要（英文）: OBJECTIVE: We aimed to explore the alteration in topology and network properties in self-referential-related brain regions of individuals with depersonalization-derealization disorders (DPD), using evidence from resting-state functional magnetic resonance imaging (rs-fMRI). METHODS: We first determined the regions of interest (ROIs) using Neurosynth, based on which we conducted an ROI-wise functional connectivity search to create a self-referential-related network and performed a topographical analysis. We then compared the analyzed properties from the rs-fMRI of disordered individuals to those of healthy controls to generate differential properties, based on which we conducted a machine learning-based disease diagnostic model. RESULTS: The study found significant changes in connectivity between brain regions associated with self-referential processing in individuals with DPD compared to healthy controls. Correlation analysis showed negative correlations between "unreality of surroundings" and connectivity between the left inferior frontal gyrus (IFG) pars orbitalis and left insula and between "perceptual alterations" and connectivity between the left pregenual and subgenual anterior cingulate cortex (ACC). Graph theoretical analysis revealed increased local and global efficiency but decreased characteristic path length. The accuracy of the classification model was 0.885, and the area under the curve was 0.928. CONCLUSIONS: Individuals with DPD showed alterations in brain topography and changes in network properties within self-referential-related brain regions; specifically, the changes in cortical midline structures and insula could be related to the underlying mechanism of DPD, highlighting potential targets for future research and therapeutic strategies.

一句话概括: DPD患者自我参照脑区网络特性改变，机器学习可高精度识别DPD。

[8] Self-portrait of a stranger: Self-face representation and interoception in depersonalization experiences​

作者: Maister L.; Ciaunica A.
年份: 2025
DOI: 10.1016/j.cognition.2025.106261
原文链接: 无
PubMed: [https://pubmed.ncbi.nlm.nih.gov/?term=10.1016/j.cognition.2025.106261](https://pubmed.ncbi.nlm.nih.gov/?term = 10.1016/j.cognition.2025.106261)

摘要（中文）: 本研究首次探讨DPD患者长期自我面孔表征的损害。DPD症状较重的个体自我面孔表征准确率较低但精确度和信息含量反而较高，提示他们可能将一个不同但不准确的"陌生"面孔表征为自我。独立评估者发现高DPD参与者的自我表征面孔更冷漠、更年轻，且与内感受敏感性相关。

摘要（英文）: Depersonalization is a condition that makes people feel detached from one's self, body and others. The representation of one's own face is a salient bodily aspect of self-awareness and identity, and empirical evidence suggests that individuals with depersonalization disorder experience disrupted perception of their faces when viewing themselves in photographs or in the mirror, which has been corroborated by first-person reports. However, no study had yet explored the state of long-term self-face representations stored in visual memory in the context of depersonalization. By visualizing how individuals saw themselves "in the mind's eye", this study provides the first empirical evidence for a relationship between depersonalization symptoms and impairments in self-face representation. Individuals reporting more frequent and intense depersonalization symptoms had lower self-face representation accuracy, but somewhat counterintuitively, also higher precision and informational content of this representation. These results suggested that individuals with high depersonalization were representing a distinct, but inaccurate, facial identity as themselves. The self-face representations of high-depersonalization participants were rated as visibly more emotionless and younger in appearance than those of low-depersonalisation participants, according to independent raters. These features were found to be specifically related to aspects of depersonalization symptomatology related to anomalous memory experiences. Finally, an intriguing role of interoceptive sensibility was revealed in both self-face representational accuracy and in depersonalization symptoms. These novel results highlight the link between interoceptive and exteroceptive bodily self-awareness and memory processes as important in those individuals who experience distressing feelings of being detached from one's self, body and the world.

一句话概括: DPD患者自我面孔表征不准确但精确度反而增高，与内感受敏感性相关。

[9] Depersonalization disorder: Directed forgetting as a function of emotionality​

作者: Simeon D.; Knutelska M.
年份: 2023
DOI: 10.1080/15299732.2022.2136328
原文链接: 无
PubMed: [https://pubmed.ncbi.nlm.nih.gov/?term=10.1080/15299732.2022.2136328](https://pubmed.ncbi.nlm.nih.gov/?term = 10.1080/15299732.2022.2136328)

摘要（中文）: 本研究探讨DPD患者对情绪信息的主动遗忘能力。DPD组对负性词的定向遗忘显著低于对照组，且解离评分与负性词的反向遗忘相关，提示DPD患者在主动控制注意力以回避情绪困扰方面存在缺陷。

摘要（英文）: There exists some evidence for a link between dissociation and emotionally avoidant information processing, yet studies to date have been contradictory. Our goal was to investigate emotionally avoidant processing in Depersonalization Disorder (DDD) using a directed forgetting (DF) paradigm. Thirty-two participants with DSM-IV DDD and 40 healthy controls performed an item-method DF task using positive, negative, and neutral words. Participants were also administered the Dissociative Experiences Scale (DES) and the Childhood Trauma Questionnaire (CTQ). The DDD group demonstrated significantly lower directed forgetting for negative, but not positive or neutral, words compared to controls. In the combined sample, DES total, depersonalization/derealization, and amnesia scores significantly inversely predicted explicit cued recall for to-be-forgotten negative words (higher dissociation, lower forgetting), while the CTQ was not predictive. The findings do not support emotionally avoidant processing in this paradigm; rather, DDD may be characterized by a diminished capacity to actively control attention and direct it away from emotionally disturbing material when instructed to do so.

一句话概括: DPD患者对负性情绪词主动遗忘能力受损，无法有效转移注意力。

[10] Behavioural, autonomic, and neural responsivity in depersonalisation-derealisation disorder: A systematic review of experimental evidence.​

作者: Millman L.; Huang X.; Wainipitapong S.; Medford N.; Pick S.
年份: 2024
DOI: 10.1016/j.neubiorev.2024.105783
原文链接: https://linkinghub.elsevier.com/retrieve/pii/S0149763424002525
PubMed: [https://pubmed.ncbi.nlm.nih.gov/?term=10.1016/j.neubiorev.2024.105783](https://pubmed.ncbi.nlm.nih.gov/?term = 10.1016/j.neubiorev.2024.105783)

摘要（中文）: 本系统综述综合了DDD患者行为、自主神经和神经反应性的实验证据。研究发现DDD患者对厌恶刺激的主观反应性降低、情绪调节相关神经回路过度激活，但行为和自主神经反应性结果不一致。常见混杂因素包括小样本量、药物使用和共病。

摘要（英文）: Depersonalisation-derealisation disorder (DDD) is characterised by distressing experiences of separation from oneself and/or one's surroundings, potentially resulting from alterations in affective, cognitive, and physiological functions. This systematic review aimed to synthesise current experimental evidence of relevance to proposed mechanisms underlying DDD, to appraise existing theoretical models, and to inform future research and theoretical developments. Studies were included if they tested explicit hypotheses in DDD samples, with experimental manipulations of at least one independent variable, alongside behavioural, subjective, neurological, affective and/or physiological dependent variables. Some evidence for diminished subjective responsivity to aversive images and sounds, and hyperactivation in neurocircuits associated with emotional regulation when viewing aversive images emerged, corroborating neurobiological models of DDD. Inconsistencies were present regarding behavioural and autonomic responsivity to facial expressions, emotional memory, and self-referential processing. Common confounds included small sample sizes, medication, and comorbidities. Alterations in affective reactivity and regulation appear to be present in DDD; however, further research employing more rigorous research designs is required to provide stronger evidence for these possible mechanisms.

一句话概括: DDD存在情绪反应性降低和神经调控异常，但现有证据尚不充分。

[11] Depersonalization-derealization disorder: Etiological mechanism, diagnosis and management​

作者: Wilkhoo H.; Islam A.; Reji F.; Sanghvi L.; Potdar R.; Solanki S.
年份:
DOI: 10.15190/d.2024.09
原文链接: https://pmc.ncbi.nlm.nih.gov/articles/PMC11910194/
PubMed: [https://pubmed.ncbi.nlm.nih.gov/?term=10.15190/d.2024.09](https://pubmed.ncbi.nlm.nih.gov/?term = 10.15190/d.2024.09)

摘要（中文）: 本综述深入探讨DPDR的复杂性问题，涵盖临床表现、流行病学、病因学、诊断和管理。DPDR确切病因仍不明确，但影像学研究提示与脑白质、灰质、尾状核、杏仁核等结构功能改变相关。治疗需整合心理治疗、药物治疗和生活方式干预，CBT和SSRIs/SNRIs是主要干预手段。

摘要（英文）: This comprehensive review delves into the complexities surrounding Depersonalization-Derealization disorder (DPDR), a dissociative disorder characterized by enduring feelings of detachment from one's self and surroundings. Tracing its historical roots back to 19th-century descriptions and its current classification as a singular disorder, the review meticulously explores the clinical presentation, epidemiology, etiology, diagnosis, and management of DPDR. Despite many trials and studies conducted the exact cause of this condition is still unknown. The best way to understand its etiology is by taking into account its clinical presentations and linking it to different structural and functional alterations of the brain. Alteration in cortical activity and structure associated with white matter, gray matter, caudate nucleus, amygdala, and other areas like Broadman's areas of cortex are analyzed to be potential mechanisms for etiology. With a concerning rise in its prevalence globally and notable impact on adolescents and young adults, DPDR manifests through a spectrum of symptoms including depersonalization, and derealization, and often accompanies comorbidities such as anxiety and depression. While the precise cause remains elusive, factors such as traumatic experiences, stress, and genetic predispositions have been implicated, with modern neuroimaging studies offering insight into potential structural and functional brain alterations. Managing DPDR necessitates a multifaceted approach integrating psychotherapy, pharmacotherapy, and lifestyle interventions, with cognitive-behavioral therapy (CBT) and pharmacological agents like SSRIs and SNRIs emerging as primary interventions. The importance of early detection and intervention is crucial for improving its prognosis. Unfortunately, DPDR is highly understudied to date. Due to a scarcity of scientific literature about DPDR in recent years, it has become very challenging to get a proper in-depth understanding of this condition.

一句话概括: DPDR是多因素复杂疾病，需综合干预，早期识别对预后至关重要。

:::info 贡献者 文献来源于 Zotero 库，已获得授权整理。如需添加或修改内容，欢迎提交 PR。 :::