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SYSTEMATIC REVIEW article

Front. Psychol.

Sec. Psychopathology

Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1531633

Depersonalisation-derealisation as a transdiagnostic treatment target: A scoping review of the evidence in anxiety, depression, and psychosis

Provisionally accepted
Emma Černis Emma Černis 1*Milan Antonović Milan Antonović 1Roya Kamvar Roya Kamvar 2Joe Perkins Joe Perkins 3[Group Author] The Transdiagnostic DPDR Project Lived Experience [Group Author] The Transdiagnostic DPDR Project Lived Experience 3
  • 1 University of Birmingham, Birmingham, United Kingdom
  • 2 The McPin Foundation, London, United Kingdom
  • 3 None, None, United Kingdom

The final, formatted version of the article will be published soon.

    Depersonalisation and derealisation (DPDR) describe dissociative experiences involving distressing feelings of disconnection from oneself or one's surroundings. Such experiences are common transdiagnostically across the range of mental health presentations, with evidence to suggest they may even play an active role in the development and maintenance of other mental health concerns. If substantiated, DPDR could present a plausible novel transdiagnostic treatment target. The objective of this scoping review was to therefore to synthesise the evidence-base regarding DPDR as a transdiagnostic target for the treatment of anxiety, depression, and psychosis, in order to evaluate this proposal for each.Embase, Ovid MEDLINE, APA PsychInfo, Scopus, and PubMed were searched for empirical published research and 'grey' literature addressing transdiagnostic DPDR and primary anxiety, depression, or psychotic disorders (time range: 1993 to 12 th October 2023). Extracted data were summarised and provided to the Lived Experience Advisory Panel for interpretation and analysis.We screened 3740 records, resulting in 42 studies addressing DPDR in the context of psychosis, 28 in anxiety, and 24 in depression.The results indicate that transdiagnostic DPDR is highly likely to be a viable treatment target in psychosis, and that it may share common cognitive processes with anxiety disorders. Evidence for the feasibility of DPDR as a treatment target in depression was sparse, and thus inconclusive.Whilst no established interventions targeting transdiagnostic DPDR were identified by this review, its findings highlight many viable options for treatment development. Given the difficulty drawing clinically meaningful conclusions from the current evidence-base, we strongly recommend that this work actively involves people with lived experience of DPDR.

    Keywords: Anxiety, Depersonalization, Depression, derealization, dissociation, intervention, psychosis, Treatment

    Received: 20 Nov 2024; Accepted: 24 Mar 2025.

    Copyright: © 2025 Černis, Antonović, Kamvar, Perkins and The Transdiagnostic DPDR Project Lived Experience. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Emma Černis, University of Birmingham, Birmingham, United Kingdom

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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