DEPERSONALIZATION-DEREALIZATION DISORDER WITH ACUTE AND PROGRESSIVE ONSET: COMPARISON OF CLINICAL CASES

Abstract

Abstract. Introduction. The prevalence of depersonalization-derealization disorder (DDD) among psychiatric patients determines the relevance of the research topic. Analysis of recent research and publications. The pathophysiological mechanism of depersonalization still remains unclear. The triggering mechanism for the development of depersonalization-derealization disorder can be: psychotraumatic events, the effect of psychoactive substances, the effect of medications, the development of another mental illness, etc. In some cases, the disease begins acutely, in others, the symptoms gradually increase. Patients with ADHD are prone to excessive self-reflection with compulsive scanning of their feelings. As psychological defense mechanisms, such stress-coping strategies as social isolation, self-blame, and rumination are characteristic of them. Formulation of the problem. The phenomenon of depersonalization is a “negative” symptom”, therefore, for the patient, it is difficult to verbalize and explain, which makes it difficult to detect it in patients in a timely manner and carry out qualitative differential diagnosis. Formulation of the purpose of the research. The goal is to carefully study cases of DDR in individual patients in order to improve diagnostics and therapeutic approaches for these disorders. Research materials and methods. Analytical, clinical, clinical-psychopathological, pathopsychological, psychodiagnostic, comparative methods were used in the research. A block of psychometric scales was used to psychometrically assess the condition of the patients: the Hamilton Anxiety Assessment Scale (HAM-A), the Beck Hopelessness Scale (BHI), the Sheehan Anxiety Self- Assessment Scale (SPRAS), the Cambridge Depersonalization Questionnaire (CDS), the Dissociation Scale (DES), the test of sensolife orientations in Leontiev’s adaptation (SZHO), the Big Five Inventory test. Research results. Despite the differences in etiological factors, the pathogenetic mechanism of DDR development was common in both clinical cases. The use of a combination of escitalopram and lamotrigine produced significant improvement for both patients, but without complete reduction of symptoms. Conclusions and prospects for further research. Differences in the etiological factors of the development of DDR were revealed, but the similarity of the pathogenetic mechanism of development, which should be taken into account when determining the strategy of complex treatment of patients with the use of psychopharmacotherapy and psychotherapeutic intervention to increase its effectiveness. The lack of a clear view of the neurobiological and neurochemical processes underlying ADHD requires further study of the pathogenetic mechanisms of these disorders.