The Affective depersonalization (items 42-49) domain explores the patient's loss of ability to imbue perceptions with emotional feelings but also comprises the loss of affection, pleasure, fear or disgust to situations previously avoided. The Autopsychic depersonalization (items 26-41) domain includes the unfamiliarity of the Self in terms of sensation of being an outside observer of one's mental process, not being "in charge" of their own behavior or mental processes, the automaton-like experience and anomalous subjective recall (e.g., the feeling that personal events happened long ago or had already happened, inability to evoke visual memories of people or places).
Somatosensory distortions, usually affecting the size of body parts, or feeling very light, and lack of body sensations or various types of sensory anesthesia (e.g., hunger, thirst, and pain) are also present. The Somatopsychic depersonalization (items 10-25) domain describes a variety of changes in body experience such as lack of body ownership feelings, feelings of disembodiment, which can range from a nonspecific feeling of not being in the body to out-of-body experiences and autoscopic hallucinations. Such an experience is frequently described in terms of visual metaphors (e.g., looking through the fog, a veil between you and the external world). The first domain, Derealization (items 1-9), encompasses all items referring to an altered experience of the external world, and corresponds to the DSM description of derealization. The information obtained guided the rephrasing of some questions.
When DP symptoms occur during alcohol or drug intake, items are coded as negative.Īn initial version of the scale was piloted in patients with depersonalization disorder (DPD) and comments were also solicited from researchers with experience in scale construction. Items responses are coded in a dichotomous way (yes/no) and total and domain scores are obtained by counting the number of positive answers. It includes 49 items exploring "presence" or "absence" of lifetime spontaneous symptoms of depersonalization (DP) organized into four domains: (1) Derealization, (2) Somatopsychic depersonalization, (3) Autopsychic depersonalization, and (4) Affective depersonalization. The SCI-DER was developed at the Departments of Psychiatry, Neurobiology, Pharmacology, and Biotechnologies of the University of Pisa by experienced psychiatrists.
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