Depersonalization

DEPERSONALIZATION, the loss of the sensation of one's own personality. This peculiar experience consists of an absence of the consciousness of one's own mental activity and a feeling of alienation from one's own perceptions. The patient's thoughts and actions arise as if by inertia, unaccompanied by a feeling of a direct, intimate connection with their personality. Hence the comparison of oneself to an automaton, a puppet, etc. The patient looks at themselves indifferently, as if from the outside. The features of their own face in the mirror and the sound of their own voice seem alien and unfamiliar to them, and the sensations arising in the body are deprived of that intimate nuance which gives them a personal character. Perceptions of the external world undergo a similar transformation: everything happening around seems soulless, unreal, ghostly, colors seem dull, and surrounding objects are perceived as if through a haze. ("I stand as if before a cabinet of curiosities," writes Goethe's Werther, "watching the little men and horses move before me, and I often ask myself if it is not an optical illusion. I play too, or rather, I am played with like a puppet, and sometimes I grab my neighbor by his wooden hand and shrink back in horror.") In more severe cases, patients complain of a complete loss of their "I", of a feeling of absolute loss of the sensation of life (becoming "like the dead"), of a complete inability to retain traces of perceptions, etc. Depersonalization represents a symptom of mental weakness (or inhibition), on the one hand appearing episodically, predominantly in constitutional asthenics during states of depression caused by overwork or unpleasant experiences, and on the other hand accompanying the depressions of circular patients and the initial phenomena of sluggishly progressing forms of schizophrenia.

P. Zinoviev. DEPIGMENTATION, a temporary or permanent focal loss of normal skin pigmentation, is of two kinds: 1. Secondary, occurring at the site of former inflammatory or inflammatory-degenerative dermatoses, more often in cases with the formation of a scar or cicatricial atrophy (tubercular or gummatous syphilid, lichen planus sclerosus, atrophying dermatitis, sclerosing radiodermatitis, etc.), less often in cases without scar formation (syphilitic leukoderma, confluent papular syphilid, leprous erythema or infiltrate, etc.). 2. Primary, in which the changes are reduced to the absence (usually congenital) of pigment in the epidermal cells and chromatophores in the skin, in which case the Dopa reaction is unsuccessful. (See also Vitiligo.)