Evidence map›Paper›PMID 41373023›Full record

ArticlePilot and feasibility studies2025

Cognitive Behavior Therapy for Depersonalization-Derealization Disorder (CBT-f-DDD): a feasibility randomized trial.

Elaine C M Hunter, Lucy Ring, Rafael Gafoor, Nicola Morant, Glyn Lewis, Joe Perkins, Nicola Dalrymple, Ana Dumitru, Cheuk Lon Malcolm Wong, Elena Pizzo and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pilot and feasibility studies, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

12 authors.

Elaine C M HunterDivision of Psychiatry, University College London, London, UK. e.hunter@ucl.ac.uk.ORCID http://orcid.org/0000-0002-6479-2954
Lucy RingDivision of Psychiatry, University College London, London, UK.
Rafael GafoorComprehensive Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK.
Nicola MorantDivision of Psychiatry, University College London, London, UK.
Glyn LewisDivision of Psychiatry, University College London, London, UK.
Joe PerkinsUnreal Charity, Bristol, UK.
Nicola DalrympleDivision of Psychiatry, University College London, London, UK.
Ana DumitruDivision of Psychiatry, University College London, London, UK.
Cheuk Lon Malcolm WongDivision of Psychiatry, University College London, London, UK.
Elena PizzoDepartment of Primary Care and Population Health, University College London, London, UK.
Georgia McRedmondComprehensive Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK.
Anthony S DavidDivision of Psychiatry, University College London, London, UK.

Funding

Research for Patient Benefit Programme PB-PG-NIHR202201
6 · The paper itself

Abstract

backgroundDepersonalization-derealization disorder (DDD) is characterized by feelings of "unreality" about the self and/or external world. Cognitive Behavioral Therapy adapted for DDD (CBT-f-DDD) has been effective in published clinical audits. This study aimed to provide feasibility and acceptability data.

methodsAn individually randomized design of CBT-f-DDD versus Treatment as Usual (TAU) was carried out with adult DDD participants from NHS Trusts in London. The CBT-f-DDD group received individual sessions over a 6-month period from CBT therapists. Qualitative interviews were conducted with CBT-f-DDD participants and their clinicians. Eight feasibility objectives were evaluated (recruitment, retention, resources, representativeness, acceptability of study design and intervention, preliminary responses to intervention, and health economics).

resultsThirty participants with DDD were recruited over 13 months. Only 63% completed the final assessment, so retention needs improvement. Resources were acceptable. The sample was comparable to previous studies, although younger, with a shorter duration of DDD and lower mean DDD scores. In a post-study questionnaire, no aspect of the study or treatment was rated unacceptable; however, some areas need improvement. Qualitative interviews with participants and clinicians recorded positive responses to CBT-f-DDD. Those in the CBT arm had a mean decrease of 16.9 points (SD 43.6) on the Cambridge Depersonalization Scale versus a mean decrease of 5.5 points (SD = 25.0) for the TAU arm. Health economics analyses found that CBT-f-DDD saved £153 per person. Participants reported an additional 0.08 Quality-Adjusted Life Years at low cost.

conclusionsThis study suggests that a subsequent RCT for CBT-f-DDD is feasible and represents the first step in the process of establishing evidence-based treatments for DDD. However, refinements to the current design and delivery were indicated for a future fully powered definitive RCT of CBT-f-DDD.

trial registrationISRCTN, ISRCTN97686121. Retrospectively registered 5 January 2023: https://doi.org/10.1186/ISRCTN97686121.

Indexed as

CBTDepersonalizationDerealizationFeasibilityRCT

Identifiers

PMID41373023
PMCPMC12801544

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.