Evidence-based treatment for Depersonalisation-derealisation Disorder (DPRD)

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dc.contributor.authorSomer, Elien_ZA
dc.contributor.authorAmos-Williams, Tarynen_ZA
dc.contributor.authorStein, Danen_ZA
dc.date.accessioned2015-11-27T09:34:29Z
dc.date.available2015-11-27T09:34:29Z
dc.date.issued2013en_ZA
dc.description.abstractBACKGROUND: Depersonalisation-derealisation disorder (DPRD) is a distressing and impairing condition with a pathophysiology that is not well understood. Nevertheless, given the growing interest in its pathogenesis, and the publication of a number of treatment trials, a systematic review of randomised controlled pharmacotherapy and psychotherapy trials is timely. METHODS: A systematic search of articles on DPRD published from January 1980 to August 2012, using Cochrane methods, was conducted. All randomised controlled trials (RCTs) of pharmacotherapy, psychotherapy, somatic interventions and a blend of these modalities for the treatment of depersonalisation disorder were included in the review. Searches were carried out on multiple databases. The bibliographies of all identified trials were checked for additional studies and authors were contacted for published trials. No unpublished trials were found and no restrictions were placed on language and setting. Data extraction sheets were further designed to enter specified data from each trial and risk of bias information was identified. PRISMA guidelines were also followed to ensure that our methodology and reporting were comprehensive. Of the unique 1296 papers that were retrieved, four studies met the inclusion criteria and were reviewed. RESULTS: Four RCTs (all within the duration of 12 weeks or less) met study criteria and were included (180 participants; age range 18-65 years). The four RCTs included two lamotrigine studies, one fluoxetine study and one biofeedback study. Evidence for the treatment efficacy of lamotrigine was found in one study (Cambridge Dissociation Scale, CDC: p < 0.001) with no evidence of effect for lamotrigine in the second study (CDS: p = 0.61 or Present State Examination: p = 0.17). Fluoxetine and biofeedback were not more efficacious than the control condition, although there was a trend for fluoxetine to demonstrate greater efficacy in those with comorbid anxiety disorder. The four studies had 'low' or 'unclear' risk of bias. CONCLUSION: The limited data from randomised controlled trials on the pharmacotherapy and psychotherapy of DPRD demonstrates inconsistent evidence for the efficacy of lamotrigine, and no efficacy for other interventions. Additional research on this disorder is needed.en_ZA
dc.identifier.apacitationSomer, E., Amos-Williams, T., & Stein, D. (2013). Evidence-based treatment for Depersonalisation-derealisation Disorder (DPRD). <i>BMC Psychology</i>, http://hdl.handle.net/11427/15408en_ZA
dc.identifier.chicagocitationSomer, Eli, Taryn Amos-Williams, and Dan Stein "Evidence-based treatment for Depersonalisation-derealisation Disorder (DPRD)." <i>BMC Psychology</i> (2013) http://hdl.handle.net/11427/15408en_ZA
dc.identifier.citationSomer, E., Amos-Williams, T., & Stein, D. J. (2013). Evidence-based treatment for depersonalisation-derealisation disorder (DPRD). BMC psychology, 1(1), 20.en_ZA
dc.identifier.ris TY - Journal Article AU - Somer, Eli AU - Amos-Williams, Taryn AU - Stein, Dan AB - BACKGROUND: Depersonalisation-derealisation disorder (DPRD) is a distressing and impairing condition with a pathophysiology that is not well understood. Nevertheless, given the growing interest in its pathogenesis, and the publication of a number of treatment trials, a systematic review of randomised controlled pharmacotherapy and psychotherapy trials is timely. METHODS: A systematic search of articles on DPRD published from January 1980 to August 2012, using Cochrane methods, was conducted. All randomised controlled trials (RCTs) of pharmacotherapy, psychotherapy, somatic interventions and a blend of these modalities for the treatment of depersonalisation disorder were included in the review. Searches were carried out on multiple databases. The bibliographies of all identified trials were checked for additional studies and authors were contacted for published trials. No unpublished trials were found and no restrictions were placed on language and setting. Data extraction sheets were further designed to enter specified data from each trial and risk of bias information was identified. PRISMA guidelines were also followed to ensure that our methodology and reporting were comprehensive. Of the unique 1296 papers that were retrieved, four studies met the inclusion criteria and were reviewed. RESULTS: Four RCTs (all within the duration of 12 weeks or less) met study criteria and were included (180 participants; age range 18-65 years). The four RCTs included two lamotrigine studies, one fluoxetine study and one biofeedback study. Evidence for the treatment efficacy of lamotrigine was found in one study (Cambridge Dissociation Scale, CDC: p < 0.001) with no evidence of effect for lamotrigine in the second study (CDS: p = 0.61 or Present State Examination: p = 0.17). Fluoxetine and biofeedback were not more efficacious than the control condition, although there was a trend for fluoxetine to demonstrate greater efficacy in those with comorbid anxiety disorder. The four studies had 'low' or 'unclear' risk of bias. CONCLUSION: The limited data from randomised controlled trials on the pharmacotherapy and psychotherapy of DPRD demonstrates inconsistent evidence for the efficacy of lamotrigine, and no efficacy for other interventions. Additional research on this disorder is needed. DA - 2013 DB - OpenUCT DO - 10.1186/2050-7283-1-20 DP - University of Cape Town J1 - BMC Psychology LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Evidence-based treatment for Depersonalisation-derealisation Disorder (DPRD) TI - Evidence-based treatment for Depersonalisation-derealisation Disorder (DPRD) UR - http://hdl.handle.net/11427/15408 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15408
dc.identifier.urihttp://dx.doi.org/10.1186/2050-7283-1-20
dc.identifier.vancouvercitationSomer E, Amos-Williams T, Stein D. Evidence-based treatment for Depersonalisation-derealisation Disorder (DPRD). BMC Psychology. 2013; http://hdl.handle.net/11427/15408.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2013 Somer et al.; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Psychologyen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcpsychol/en_ZA
dc.subject.otherDepersonalisation disorderen_ZA
dc.subject.otherDerealisation disorderen_ZA
dc.subject.otherDepersonalisation-derealisation disorderen_ZA
dc.subject.otherDepersonalisation syndromeen_ZA
dc.subject.otherDerealisation syndromeen_ZA
dc.subject.otherDepersonalisation-derealisation syndromeen_ZA
dc.titleEvidence-based treatment for Depersonalisation-derealisation Disorder (DPRD)en_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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