Psicopatologia da despersonalização

[摘要] 1- From a clinical-nosographical point of view depersonalization appear in a pure state (relative), as a neurosis and in the neurosis, as a psychosis and in the psychosis. 2- Depersonalization can be defined as a state in which the patients feels different to what he was formerly in the body-ego, the psychic-ego and in his relation to the outer world. The terminology of Wernicke seems satisfactory: somatopsychic, autopsychic and alopsychic depersonalization (strangeness of the world or disrealization of Mapother-Mayer-Gross). 3- Depersonalization can reach partial aspects or the total body and psychic-ego; alienation or strangeness of this or that organ or part of the body or the whole body; the emotions, ideas, or volitions as the totality of the psyche. In extreme cases there arises the picture of the delusion of negation or phenomena of "double conscience" or multiple personality. 4- Approaching the cases of depersonalization with some neurological ones (hallucination of amputed limbs, anosognosia, autoscopia) brings certain explanations as to its neuro-pathogenic mechanisms. But here it is question, as Krapf shows, of instrumental phenomena farther away from the ego than authentic depersonalization (Krapf refers to the cases of disrealization with hemianopsia or hemianosognosia studied by Ehrenwald, von Stöckrt and Krapf). Besides this, the mere considerations of neuro-anatomo-pathological mechanisms (in the case still obscures) would not be able to explain the psychodynamic of the depersonalization. 5- In our cases the clinical examination (with many complementary proofs) was negative as to the existence of organic affection (in a strict sense) of the nervous system.