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Open Access 01-12-2024 | Mood Disorders | Research

Impact of depersonalization on the course of depression: longitudinal observations from the gutenberg health study

Authors: Matthias Michal, Jörg Wiltink, Ana N. Tibubos, Philipp S. Wild, Thomas Münzel, Karl Lackner, Norbert Pfeiffer, Jochem König, Alexander Gieswinkel, Manfred Beutel, Jasmin Ghaemi Kerahrodi

Published in: BMC Psychiatry | Issue 1/2024

Abstract

Background

Symptoms of depersonalization (DP) and derealization (DR) are a risk factor for more severe impairment, non-response to various treatments, and a chronic course. In this study, we investigated the effects of DP/DR symptoms in patients with clinically significant depressive symptoms on clinical characteristics and various outcomes in a representative population-based sample with a 5-year follow-up.

Methods

The middle-aged sample comprised n = 10,422 persons at baseline, of whom n = 9,301 were free from depressive and DP/DR symptoms. N = 522 persons had clinically significant depression (PHQ-9 ≥ 10) and co-occurring DP/DR symptoms, and n = 599 persons had clinically significant depression (PHQ-9 ≥ 10) without DP/DR symptoms.

Results

There were substantial health disparities between persons with and without depression. These disparities concerned a wide range of life domains, including lower quality of the recalled early life experiences with the parents, current socioeconomic status, social integration (partnership, loneliness), current social and interpersonal stressors (family, work), functional bodily complaints (e.g., tinnitus, migraine, chest pain), unhealthy lifestyle, and the prevalence of already developed physical diseases. These disparities persisted to the 5-year follow-up and were exceptionally severe for depressed persons with co-occurring DP/DR symptoms. Among the depressed persons, the co-occurrence of DP/DR symptoms more than doubled the risk for recurrence or persistence of depression. Only 6.9% of depressed persons with DP/DR symptoms achieved remission at the 5-year follow-up (PHQ-9 < 5). Depression with and without co-occurring DP/DR worsened self-rated physical health significantly. The impact of depression with co-occurring DP/DR on the worsening of the self-rated physical health status was stronger than those of age and major medical diseases (e.g., heart failure). However, only depression without DP/DR was associated with mortality in a hazard regression analysis adjusted for age, sex, and lifestyle.

Conclusions

The results demonstrated that DP/DR symptoms represent an important and easily assessable prognostic factor for the course of depression and health outcomes. Given the low remission rates for depression in general and depression with DP/DR in particular, efforts should be made to identify and better support this group, which is disadvantaged in many aspects of life.

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Title: Impact of depersonalization on the course of depression: longitudinal observations from the gutenberg health study
Authors: Matthias Michal
Jörg Wiltink
Ana N. Tibubos
Philipp S. Wild
Thomas Münzel
Karl Lackner
Norbert Pfeiffer
Jochem König
Alexander Gieswinkel
Manfred Beutel
Jasmin Ghaemi Kerahrodi
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Mood Disorders
Affective Disorder
Published in: BMC Psychiatry / Issue 1/2024
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-024-05658-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of depersonalization on the course of depression: longitudinal observations from the gutenberg health study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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