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Annals of Clinical and Translational... Sep 2019Depersonalization refers to the sensation of being detached from one's body, often associated with feelings of loss of control over one's own body, actions, or thoughts....
OBJECTIVE
Depersonalization refers to the sensation of being detached from one's body, often associated with feelings of loss of control over one's own body, actions, or thoughts. Derealization refers to the altered perception of one's surroundings that is experienced as unreal. Although usually reported by psychiatric patients suffering from depression or anxiety, single case reports and small case series have described depersonalization- and derealization-like symptoms in the context of epilepsy.
METHODS
We investigated the brain mechanisms of ictal depersonalization- and derealization like symptoms by analyzing clinical and neuropsychological data as well as the epileptogenic zone based on a multimodal approach in a group of patients reporting depersonalization- (n = 9) and derealization-like symptoms (n = 7), from a single presurgical epilepsy center with focal epilepsy. We compared them with a group of control patients with experiential phenomena due to temporal lobe epilepsy (n = 28).
RESULTS
We show that all patients with ictal depersonalization-like symptoms report altered self-identification with their body and mostly suffer from frontal lobe epilepsy with the epileptogenic zone in the dorsal premotor cortex, while patients with derealization-like symptoms suffer from temporal lobe epilepsy. This finding is supported by post-ictal neuropsychological deficits, showing that depersonalization-like symptoms were significantly more often associated with frontal lobe dysfunction as compared to the control patients and patients with derealization-like symptoms.
CONCLUSION
We argue that depersonalization of epileptic origin constitutes a distinct disorder due to frontal lobe epilepsy. We discuss these findings with respect to earlier accounts of depersonalization and the recent concept of bodily self-consciousness.
Topics: Adult; Brain; Brain Mapping; Depersonalization; Electroencephalography; Epilepsy; Female; Humans; Magnetic Resonance Imaging; Male; Neuropsychological Tests; Retrospective Studies
PubMed: 31437864
DOI: 10.1002/acn3.50870 -
Frontiers in Neurology 2020
PubMed: 32153485
DOI: 10.3389/fneur.2020.00022 -
Military Medicine Jan 2022Burnout has reached epidemic levels among resident physicians. Characterized by emotional exhaustion (EE), depersonalization, and feelings of inefficacy, burnout...
INTRODUCTION
Burnout has reached epidemic levels among resident physicians. Characterized by emotional exhaustion (EE), depersonalization, and feelings of inefficacy, burnout negatively affects patient outcomes, increases costs, and decreases physician quality of life. These negative outcomes catalyze leaders in graduate medical education to address burnout and reverse its trends. The primary aim of this project is to design a residency Wellness Program utilizing the facets of physician wellness, assess levels of burnout among resident physicians, and determine the program's effects on burnout.
MATERIALS AND METHODS
A Wellness Program was formalized at a Midwestern, military-civilian Obstetrics and Gynecology residency program for the 2019-2020 academic year. Resident wellness and perceptions were assessed at three time points (0, 6, and 12 months) through surveys consisting of free response, yes-no questions, and the Maslach Burnout Inventory Scales.
RESULTS
On average, 17 of 24 residents completed all three survey assessments. Perception of the residency program prioritization of wellness increased significantly from 52.9% to 94.4% (P = .007). Residents consistently demonstrated burnout throughout the year with low levels of EE, high levels of depersonalization, and moderate levels of personal achievement. Residents were consistently satisfied with their personal wellness (80%-92.9%) during the program. Residents wanted to see physical activity incorporated into the program.
CONCLUSIONS
This study assessed burnout during a formalization of a Wellness Program and insight on resident perceptions and wellness requests. Military medicine, graduate medical education, and other residency programs can utilize this research to better develop and study the implementation of wellness initiatives aimed at reducing burn out.
PubMed: 35043956
DOI: 10.1093/milmed/usac004 -
The Journal of Pediatrics Oct 2022Compare pediatrician burnout when measured and categorized in different ways to better understand burnout and the association with satisfaction.
OBJECTIVE
Compare pediatrician burnout when measured and categorized in different ways to better understand burnout and the association with satisfaction.
STUDY DESIGN
We analyzed national survey data from a cohort study of early to midcareer pediatricians. In 2017, participants randomly received 1 of 3 question sets measuring burnout components (emotional exhaustion, depersonalization, and personal accomplishment): group A received the Maslach Burnout Inventory, group B received a previously used measure, and group C received a new severe measure. Repeated measures ANOVA tested differences across burnout categorizations: high emotional exhaustion and high depersonalization and low personal accomplishment; high emotional exhaustion and high depersonalization; and high emotional exhaustion or high depersonalization. Logistic regression tested relationships between burnout profiles (engaged, intermediate, and burnout) and satisfaction. Seventy-one percent of participants completed the survey (1279/1800).
RESULTS
Burnout varied depending on measurement (groups A, B, and C) and categorization. For example, for group A, when categorized as high emotional exhaustion, high depersonalization, and low personal accomplishment, burnout was lower (4.8%) than categorized as high emotional exhaustion and depersonalization (15.2%) (P < .001) or categorized as high emotional exhaustion or depersonalization (44.6%) (P < .001). Most participants were satisfied with their career (83.6%). Using burnout profiles, 38.4%-85.1% fell in the engaged profile. For each group, burnout profiles were associated with satisfaction. For example, group A participants in the burnout or intermediate profile were less likely than those engaged to be satisfied with their careers (aOR, 0.08 [95% CI, 0.03-0.24]; and aOR, 0.23 [95% CI, 0.10-0.56], respectively).
CONCLUSIONS
The way burnout is measured and categorized affects burnout prevalence and its association with satisfaction. Transparency in methodology used is critical to interpreting results.
Topics: Burnout, Professional; Cohort Studies; Humans; Job Satisfaction; Pediatricians; Personal Satisfaction; Surveys and Questionnaires
PubMed: 35660489
DOI: 10.1016/j.jpeds.2022.05.046 -
Frontiers in Human Neuroscience 2022Depersonalization (DP) and derealization (DR) refer to states of dissociation in which one feels a sense of alienation in relation to one's self and environment,...
Depersonalization (DP) and derealization (DR) refer to states of dissociation in which one feels a sense of alienation in relation to one's self and environment, respectively. Whilst transient episodes often diminish without treatment, chronic experiences of DP and DR may last for years, with common treatments lacking a strong evidence base for their efficacy. We propose a theoretical explanation of DP and DR based on interoceptive predictive coding, and discuss how transient experiences of DP and DR may be induced in the non-clinical population using virtual reality. Further, we review the use of heartbeat evoked potentials in detecting the neural correlates of DP and DR allowing for an objective measure of these experiences in the non-clinical population. Finally, we discuss how the induction and detection of transient experiences of DP and DR in the non-clinical population could shed light on how the brain constructs one's sense of self and reality.
PubMed: 35321264
DOI: 10.3389/fnhum.2022.744487 -
Journal of the American Academy of... May 2021We describe herein the case of a patient whose primary complaints were episodic vertigo and "depersonalization," a sensation of detachment from his own body.
BACKGROUND
We describe herein the case of a patient whose primary complaints were episodic vertigo and "depersonalization," a sensation of detachment from his own body.
PURPOSE
This case study aims to further clinical knowledge and insight into the clinical evaluation of vertiginous patients with complaints of depersonalization.
RESEARCH DESIGN
This is a case study.
DATA COLLECTION AND ANALYSIS
A retrospective chart review of vestibular function testing done on a vertiginous patient with complaints of depersonalization was performed.
RESULTS
Vestibular function testing revealed absent cervical and ocular vestibular evoked myogenic potentials on the left side with normal vHIT or video Head Impulse Test, videonystagmography, and rotational chair results, suggesting peripheral vestibular impairment isolated to the left saccule and utricle.
CONCLUSION
The otolith end organ impairment explains the patient's postural deviation to the left side during attempts to ambulate. We recommend that clinicians should be attentive to patient complaints of depersonalization and perform vestibular evoked myogenic potential testing to determine whether evidence of at least a unilateral peripheral otolith end organ impairment exists.
Topics: Depersonalization; Head Impulse Test; Humans; Retrospective Studies; Saccule and Utricle; Vestibular Evoked Myogenic Potentials
PubMed: 34030195
DOI: 10.1055/s-0041-1723040 -
Arhiv Za Higijenu Rada I Toksikologiju Sep 2022The aim of this cross-sectional study was to compare occupational burnout in two groups of teachers from the district of Bijeljina (Bosnia and Herzegovina) measured with...
The aim of this cross-sectional study was to compare occupational burnout in two groups of teachers from the district of Bijeljina (Bosnia and Herzegovina) measured with the Serbian version of the Maslach Burnout Inventory survey for workers in human services (MBI-HSS) at the beginning (group 1) and the end of the school year 2018/2019 (group 2) to see if there are seasonal differences. The questionnaire also included standard sociodemographic data and job description (primary and/or secondary school position, length of service, and overtime work). The prevalence of emotional exhaustion and depersonalisation was low in both groups. However, emotional exhaustion and depersonalisation scores significantly shifted to higher values between the beginning and the end of the school year. We also found a statistically significant association between emotional exhaustion and overtime and between depersonalisation and work in a secondary school (p<0.05). These findings invite further research of occupational burnout seasonality in schoolteachers, preferably by following up cohorts which would be controlled for sociodemographic and work-related variables.
Topics: Burnout, Professional; Cross-Sectional Studies; Humans; Job Satisfaction; Seasons; Surveys and Questionnaires
PubMed: 36226818
DOI: 10.2478/aiht-2022-73-3582 -
Practical Neurology May 2024Virtual learning resources such as podcasts and social media are increasingly used in medical education. Podcasts are one example of virtual learning, where prerecorded...
Virtual learning resources such as podcasts and social media are increasingly used in medical education. Podcasts are one example of virtual learning, where prerecorded audio files are available to stream or download from the internet, usually without a fee and at any time. This gives listeners flexibility in when and where they engage with the educational material, enabling learning to be better tailored to individual needs. Podcasts are often enjoyed for their relaxed and conversational style. However, listeners must be aware of the lack of external peer review and incomplete coverage of information. There are also risks inherent to distant learning, including depersonalisation of medical education. We describe the roles that podcasts now play in neurological education, exploring some of the ways that they can be used to enhance neurological training both as a learner and educator and giving our top tips, based on our own experiences, for anyone keen to add to the expanding field of available podcasts.
PubMed: 38769014
DOI: 10.1136/pn-2024-004109 -
Revista Brasileira de Medicina Do... 2023Characterized by high levels of emotional exhaustion and depersonalization and reduced professional accomplishment, burnout syndrome has been a major cause of psychic...
INTRODUCTION
Characterized by high levels of emotional exhaustion and depersonalization and reduced professional accomplishment, burnout syndrome has been a major cause of psychic illness in nursing workers, with a serious impact on the quality of services and on patient safety.
OBJECTIVES
To analyze the correlation between organizational climate, job satisfaction, and burnout in nursing workers.
METHODS
This is a cross-sectional study with a sample of 534 Brazilian nursing workers. We used the Organizational Climate Scale for Health Organizations, the Job Satisfaction Questionnaire (S20/23), and the Maslach Burnout Inventory. An analytical descriptive analysis of the data was performed using relative and absolute frequencies, mean, standard deviation, minimum, maximum, and correlation test between the variables.
RESULTS
Organizational climate and job satisfaction were evaluated as regular. With regard to burnout, moderate levels of emotional exhaustion, low levels of depersonalization, and high levels of professional accomplishment were observed. A strong positive correlation was found between job satisfaction and organizational climate; in addition to a moderate negative correlation between emotional exhaustion and both organizational climate and job satisfaction, and a moderate negative correlation between depersonalization and job satisfaction.
CONCLUSIONS
Organizational climate and job satisfaction had a negative correlation with burnout dimensions, representing possible protective factors.
PubMed: 38313086
DOI: 10.47626/1679-4435-2022-867 -
Annual Review of Clinical Psychology May 2022For more than 30 years, the posttraumatic model (PTM) and the sociocognitive model (SCM) of dissociation have vied for attention and empirical support. We contend that... (Review)
Review
For more than 30 years, the posttraumatic model (PTM) and the sociocognitive model (SCM) of dissociation have vied for attention and empirical support. We contend that neither perspective provides a satisfactory account and that dissociation and dissociative disorders (e.g., depersonalization/derealization disorder, dissociative identity disorder) can be understood as failures of normally adaptive systems and functions. We argue for a more encompassing transdiagnostic and transtheoretical perspective that considers potentially interactive variables including sleep disturbances; impaired self-regulation and inhibition of negative cognitions and affects; hyperassociation and set shifts; and deficits in reality testing, source attributions, and metacognition. We present an overview of the field of dissociation, delineate uncontested and converging claims across perspectives, summarize key multivariable studies in support of our framework, and identifyempirical pathways for future research to advance our understanding of dissociation, including studies of highly adverse events and dissociation.
Topics: Dissociative Disorders; Humans; Metacognition; Stress Disorders, Post-Traumatic
PubMed: 35226824
DOI: 10.1146/annurev-clinpsy-081219-102424