Mr. B is a 21-year-old married college sophomore. He decided to report to the co

Question

Mr. B is a 21-year-old married college sophomore. He decided to report to the counseling center at his university after experiencing a series of strange events. The first event happened many years ago, he says. He vividly recalls, at age 10, a day when he was playing football: he was tackled by another boy and suddenly felt that his body had disappeared. This sensation was initially episodic but became continuous by age 14. He described it as "not being in this world.. .I am disconnected from my body. It is as if my body is not there." This sensation was lessened when he was alone and almost disappeared in his wife's presence. Social settings made it much worse He has recently had a couple instances in which he has been sitting in class when, all of a sudden, he gets the strange sensation that he and his professor are the only two people alive in the classroom. He can look around, but he perceives his classmates as mannequins or "fakes." His last episode terrified him because he felt convinced that most of his classmates had somehow simultaneously died. It is getting to a point where his experiences are making it hard to concentrate and work in class or when he is around others As a child, Mr. B suffered marked emotional neglect. His parents fed and clothed him but never expressed emotion; he recalled hardly ever being touched or kissed. His sense of detachment only involved his body and not other aspects of the self. Provide an appropriate diagnosis for Mr. B and rate his degree of functional impairment. Include additional information if it is available. Describe the symptoms that led to your diagnosis

Explanation / Answer

According to the symptoms reported in the question Mr. B seems to be suffering from depersonalisation-derealisation syndrome.

The degree of functional impairment seems to be minimal as he is able to carry out his day to day self care activities and other instrumental activities of daily living such as travelling. It is affecting his occupational activities though and therefore the rate of his functional impairment is minimum.

Depersonalisation-derealisation syndrome is characterised by presence of both depersonalisation-derealisation and derealisation as follows:

In the given case Mr. B suffers from a feeling of not being inside his body which is dspersonalisation. Along with that he also has alterations in perception about the external world(professor and other classmates) which is derealisation. Also his past history of emotional trauma as the precipitating factor for this disorder confirms his diagnosis.

Treatment :

Supportive psychotherapy.

Drug therapy with antidepressants might be prescribed.

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