Primary and secondary depersonalisation: A psychometric study

Introduction: Depersonalisation may be part of a symptom-complex, a primary or a secondary disorder. Optimal methods of measurement and diagnosis have not been established. Methods: We assessed 42 patients with primary or secondary depersonalisation, plus psychiatric and non-psychiatric controls using a variety of self-report questionnaire scales including the Beck depression and anxiety Inventories, and one developed by the authors (the Fewtrell Depersonalisation Scale (FDS)). The correlations between the scales and measures of anxiety and depression were calculated, as were sensitivity and specificity against an operational case definition. Results: All the scales were highly correlated. All could distinguish depersonalisation cases from the rest but none could distinguish between primary and secondary depersonalisation disorder. Anxiety and especially depression were correlated with depersonalisation symptoms. The FDS had high sensitivity (85.7%) and specificity (92.3%) which compared favourably with other instruments. Patients with both derealisation and depersonalisation scored the highest on the FDS. Discussion: Depersonalisation disorder comprises a measurable cluster of symptoms which may be quantified with the help of self-report scales. Primary and secondary forms overlap, with depressed mood a frequent feature.