Evidence map›Paper›PMID 38459472›Full record

ArticleBMC psychiatry2024

Impact of depersonalization on the course of depression: longitudinal observations from the gutenberg health study.

Matthias Michal, Jörg Wiltink, Ana N Tibubos, Philipp S Wild, Thomas Münzel, Karl Lackner, Norbert Pfeiffer, Jochem König, Alexander Gieswinkel, Manfred Beutel and 1 more

Open access · goldAbstract read
In one paragraph

Article in BMC psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
3.2field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
  5. Between Vulnerability and Connection: Longitudinal Evidence on the Impact of Transformative Religious/Spiritual Experiences.Stress and health : journal of the International Society for the Investigation of Stress · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Matthias MichalDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany. michal@uni-mainz.de.
Jörg WiltinkDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
Ana N TibubosDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
Philipp S WildPreventive Cardiology and Preventive Medicine, Department of Medicine II, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Thomas MünzelDepartment of Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Karl LacknerInstitute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Norbert PfeifferDepartment of Ophthalmology, University Medical Center Mainz, Mainz, Germany.
Jochem KönigInstitute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Alexander GieswinkelPreventive Cardiology and Preventive Medicine, Department of Medicine II, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Manfred BeutelDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
Jasmin Ghaemi KerahrodiDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
Johannes Gutenberg University Mainz · DEUniversity Medical Center of the Johannes Gutenberg University Mainz · DEGerman Centre for Cardiovascular Research · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSymptoms of depersonalization (DP) and derealization (DR) are a risk factor for more severe impairment, non-response to various treatments, and a chronic course. In this study, we investigated the effects of DP/DR symptoms in patients with clinically significant depressive symptoms on clinical characteristics and various outcomes in a representative population-based sample with a 5-year follow-up.

methodsThe middle-aged sample comprised n = 10,422 persons at baseline, of whom n = 9,301 were free from depressive and DP/DR symptoms. N = 522 persons had clinically significant depression (PHQ-9 ≥ 10) and co-occurring DP/DR symptoms, and n = 599 persons had clinically significant depression (PHQ-9 ≥ 10) without DP/DR symptoms.

resultsThere were substantial health disparities between persons with and without depression. These disparities concerned a wide range of life domains, including lower quality of the recalled early life experiences with the parents, current socioeconomic status, social integration (partnership, loneliness), current social and interpersonal stressors (family, work), functional bodily complaints (e.g., tinnitus, migraine, chest pain), unhealthy lifestyle, and the prevalence of already developed physical diseases. These disparities persisted to the 5-year follow-up and were exceptionally severe for depressed persons with co-occurring DP/DR symptoms. Among the depressed persons, the co-occurrence of DP/DR symptoms more than doubled the risk for recurrence or persistence of depression. Only 6.9% of depressed persons with DP/DR symptoms achieved remission at the 5-year follow-up (PHQ-9 < 5). Depression with and without co-occurring DP/DR worsened self-rated physical health significantly. The impact of depression with co-occurring DP/DR on the worsening of the self-rated physical health status was stronger than those of age and major medical diseases (e.g., heart failure). However, only depression without DP/DR was associated with mortality in a hazard regression analysis adjusted for age, sex, and lifestyle.

conclusionsThe results demonstrated that DP/DR symptoms represent an important and easily assessable prognostic factor for the course of depression and health outcomes. Given the low remission rates for depression in general and depression with DP/DR in particular, efforts should be made to identify and better support this group, which is disadvantaged in many aspects of life.

Indexed as

DepersonalizationDepressionHumansMiddle AgedPatient Health QuestionnaireRegression AnalysisRisk FactorsDepersonalizationDepressionDerealizationMortalityPhysical illnesses

Identifiers

PMID38459472
PMCPMC10924423
OpenAlexW4392595895

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.