David Kozin· Registered
Discussion Starter · #1 ·
The extra ribbon really helped allow me to engage other members to discuss the paper.
The brief report...
1) There is an audio record of the entire conference that I will be receiving in .mp3 format, and I will have our particular portion available for members to listen to.
2) I was one of a very few attendees to the ISSTD's DSM-V Research and Planning Committee, and both of our studies (same data) were presented as part of the evidence to help keep Depersonalization Disorder listed as a unique diagnostic entity in the Dissociative section, rather than being moved to anxiety and mood disorders.
3) I met with one of the members from the peer-review board for the Journal of Clinical Psychiatry that took part in reviewing and accepting our paper, and we had a good discussion about the unique methods that the study used to achieve such statistically robust data. Some interesting comments may be on the audio record just prior to the conference beginning regarding this.
4) My networking was very successful, and I have already been in contact with individuals from the conference.
5) Our paper presentation was essentially a cut and paste version of the tables and statistics that will appear in the JClinPsych, and in attendance were all of the members from the ISSTD's DSM-V Research and Planning Committee, one member from the very important 12-member team from the American Psychiatric Association's APA DSM-V Work Group for the Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic, and Dissociative Disorders Work Group, members from this web site, and the few others who attended the paper session, which despite its early time 8:30 AM, had more attendees than the other paper sessions I had attended. (Normally, these sessions are held in one of the 18 side rooms with 20 or so chairs, but we were in the main auditorium, which held 500 or so chairs (Good for us to get the big auditorium!) Competing against 18 other events and workshops, most that were designed to last half of the day, the turn-out from the total 400 members at the conference, I noticed attending was typical in size, but not by the quantity of ranking members. The total presentation was increased to 25 minutes.
6) I held private discussions with the new President of the ISSTD, members of the DSM-V committee, and other members in the association on a range of topics, but after writing out some of these, I have decided that those should remain private.
In general, it was a typical, self-serving professional conference, where the important part of the conference for me was related to who was paying attention to what we (NODID) were doing. I was surprised at how many individuals knew about the results of the study and knew my name before I even attended the first paper conference on the first morning -- although, this is not so mysterious after having listening to some reasons after having a meeting with Dr. Simeon.
The conclusion is simple: The general consensus among ISSTD members is that NODID has significant "research" and lobbying clout with access to so many participants and individuals that we have and did influence the perception of Depersonalization Disorder with our ability to develop research and awareness activities in larger scale than even the ISSTD can't do itself. Despite our research's limitations, the standard scale results that we used in our study were so remarkably similar on every measure compared to studies that included expensive detailed diagnostics (face-to-face interviews), that a lot of confidence is given to the vast new amount of data that we presented, and to support the final conclusion that the disorder that it has a largely uniform "phenotype" (key word) regardless if it is drug-induced or not.
There were a few moments where people commented to me on the impressive scale of the research (almost 400 participants), which also included treatment results of such a large variety of drug classes that our results had to be limited for brevity, and similarly with the list of potential precipitating drug classes. However, this was expected when you have me choosing questions regarding pharmacology. I think this was the only study that asked if 5-MeO-DiPT was a precipitating drug in the history of research. We reported (and divided the results between drug-induced and non DPD) results of symptom severity in different areas of life, number of individuals on disability, areas of impairment, suicide attempts/thoughts of suicide, psychiatric hospitalizations, age of onset, duration, episodic versus continuous DP/DR, current clinical status compared to onset, and how individuals scored in the factors we extracted in a sophisticated scale for DPD, the Cambridge Depersonalization Scale which include Numbing, Unreality of Self, Perceptual Alterations, Unreality of Surroundings, Temporal Disintegration, and drug ingestion classes with over 25 items, but only 5 were major culprits, and then also asked if polyingestions (overlapping) existed in these groups, Duration of illness at 11 time intervals, if the drug experience was considered traumatic, and more...
The paper's acceptance into the Journal of Clinical Psychiatry, the most read journal in the field of Psychiatry, was definitely noted by members that I spoke to, when we were discussing on how to get the clinical community to take notice of the seriousness of DPD and the unique responses of DPD individuals.
I did discuss future research ideas, but nothing I can reveal at this moment. More occurred in private interactions than the paper session, and NODID's main goal of the conference was to relate the research to a face for NODID, give out business cards, and listen to how the study is being used for the society's recommendation for classifying DPD -- and by all measures (including post-conference contacts), all of these objectives were extremely successful.
Our Abstract for the conference:
Is Depersonalization Disorder Initiated by Drug Use Any Different? A Survey of 394 Adults
Daphne Simeon, MD; David Kozin, BA; Karina Segal, BSc; Brenna Lerch, BA
Previous studies have documented that in a substantial minority of individuals
with depersonalization disorder, onset is first triggered by drug ingestion. The
goal of this study was to systematically compare a large sample of drug (D)
versus non-drug (ND) initiated chronic depersonalization. We conducted an
internet survey of 394 adults endorsing depersonalization and / or derealization
as defined in the DSM-IV-TR. Sixty-four questions inquired about demographic
and clinical characteristics, illness course, substance use histories, and treatment
response. The Cambridge Depersonalization Scale (CDS) was administered.
Compared to ND group (N = 198), the D group (N = 196) comprised of more
male and younger individuals. The two most common precipitating drugs were
cannabis and hallucinogens, followed by ecstasy, then ketamine. Comparison of
the D and ND groups revealed similar illness course, impairment, suicidality, and
limited treatment efficacy. The D group showed greater spontaneous improvement
over time, statistically significant but not clinically robust. The groups did
not differ in total CDS score or on the four subscale scores of unreality of self,
perceptual alterations, unreality of surroundings, and temporal disintegration.
Numbing was greater in the ND group only prior to controlling for age and gender.
The study documents the chronicity and morbidity of the depersonalization
syndrome initiated by substance use, as well as the uniform phenotype of the
syndrome regardless of antecedent.