Patients usually turn to the doctor with complaints about a sudden change in the perception of their personality, their moral appearance, their desires, aspirations, attachments or their bodies, loss of feelings and loss of confidence in their feelings. And they emphasize that they understand what it seems to them. In the descriptions appear expressions: "as if", "seemingly", "I see one thing, but it is perceived as quite different." They are usually difficult to describe the symptoms, because the sensations are often indistinct and fantastic, while the patient realizes the bias of their own sensations.
The patient can be assigned clinical laboratory tests to determine the overall level of his health status, urine analysis to detect traces of toxic substances.
Ultrasound, electroencephalography, magnetic resonance tomography is done to detect organic disorders, especially if some of the complaints do not fit into the clinical picture of the syndrome, the beginning of depersonalization with any provoking factor can not be linked, or the manifestation of the disease occurred late, for example, after the patient's forty years.
The main diagnostic tool is a test for depersonalization, which is a list of the main signs of the syndrome. The patient is asked to answer questions about what symptoms he is experiencing. The most famous questionnaire (the Nuller scale), which includes a variety of symptoms of derealization and depersonalization, is compiled by the well-known psychiatrists Yu.L. Nuller and E.L.Genkina. The test is conducted by a specialist, evaluating the patient's answers in scores. When a patient attains more than 32 points, the doctor may suspect that he has a disorder.
Diazepam test allows you to clarify the diagnosis. This method is considered reliable for distinguishing the depersonalization / derealization syndrome from anxiety disorder and depression. Developed by Professor Nuller, is the reaction of patients to the jet infusion into the vein of diazepam. The dose of the drug varies from 20 to 40 mg and depends on the age of the patient and the severity of the disorder.
In patients with depression, the clinical picture against the background of diazepam practically does not change, the drug causes drowsiness and retardation.
With an anxiety disorder, almost instantly, even during the introduction, symptoms of the disorder go through, sometimes even a slight euphoria appears.
With the syndrome of depersonalization / derealization, the reaction occurs later for 20 minutes or half an hour after the administration of the drug. There is complete or partial elimination of symptoms: patients feel the appearance of feelings and perception of the colorful real world.
The patient is examined the level of depression, the safety of the intellect and the ability to think, accentuation of character. Applying psychodiagnostic techniques, a family history, relations with relatives, psychotraumatic situations in the life of the patient, resistance to stress and anxiety level are studied.
, , ,