Phenomenological similarities between visual hypoemotionality and derealization suggest that the underlying mechanism may be a disruption of the process by means of which perception becomes emotionally colored. They tend to occur if there is coexisting vestibular dysfunction. Dp/Dr symptoms such as unambiguous self-location, egocentric visuospatial prospective, and out-of-body experience were suggested to be related to neural activity at the temporoparietal junction in epilepsy. showed by electrical stimulation in epileptic patients, a procedure initially proposed by Penfield, that the vestibular cortex at the temporoparietal junction is involved exactly in “body awareness.” In addition, they showed that a large area, the peri-sylvian vestibular cortex, is involved in spatial orientation. This is consistent with the proposal that the inferior parietal cortex is concerned with spatial orientation as well as visuomotor and vestibular function. The results of a functional imaging study of patients with depersonalization disorder suggest that abnormalities occur primarily along sequential hierarchical areas (unimodal and crossmodal) of the visual, somatosensory, and auditory processing pathways, as well as in areas responsible for the integrated body schema (specifically area 7B). The nature and localization of brain dysfunction associated with a depersonalization disorder have not yet been conclusively clarified. These symptoms are always associated with symptoms of common mental disorders. In addition, those vestibular patients who have an acquired deficiency of other special senses, for example, vision and hearing, also have more frequent and severe Dp/Dr symptoms than do healthy controls. Months later Dp/Dr symptoms in these patients decrease, but somatic symptoms of depression persist. During the acute phase of a unilateral peripheral vestibular lesion the poor spatial orientation of vestibular patients cooccurs with Dp/Dr symptoms, including attention/concentration difficulties and somatic depression symptoms. They proposed that derealization occurs in these patients because their distorted vestibular signals create a misleading frame of spatial reference, which does not match with the other senses, giving rise to illusory, “unreal” perceptions of the patient’s transactions in the physical world. have established that patients with peripheral vestibular disease often report symptoms of Dp/Dr. All this indicates the multisensory effects of vestibular stimulation. Our earlier studies also showed different unreal perceptions of self-motion, perceived unequally by the different parts of the body moreover, we discovered vestibularly evoked visual hallucinations. Abnormal vestibular stimulation with calorics has been found to provoke feelings of unreality in healthy subjects. Dp/Dr symptoms are common in the general population. Derealization (Dr) is an experience of the external world that appears strange or unreal. Introductionĭepersonalization (Dp) is an alteration in the perception or experience of the self which results in a feeling of being detached, as if one is an external observer of one’s mental processes or body. The various hypotheses about the underlying mechanism of this effect were discussed. Anxiety has an effect on depersonalization and derealization symptoms in vestibular patients. They are more frequent, more severe, and qualitatively different in vestibular patients with anxiety than in those without anxiety. The results revealed that anxiety consistently changes depersonalization and derealization symptoms in vestibular patients. They were also compared to healthy controls. Twenty-four vestibular patients with anxiety and 18 vestibular patients without anxiety were examined for depersonalization and derealization symptoms. The aim of the present study was to establish the relationship between anxiety and depersonalization and derealization symptoms in patients with peripheral vestibular disorders. Depersonalization and derealization are common symptoms reported in the general population.
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