Since the first description, by Krishaber1 in 1874, of the syndrome of unreality, many observers have amplified the available knowledge with case reports, but the number of psychoanalytically investigated cases in which the feeling of unreality or depersonalization is the predominating symptom remains small. The feeling of unreality occurs occasionally in persons whose general psychic integration is not affected by the transient experience.
Neither the feeling of unreality nor the circumscribed phenomenon of depersonalization is a morbid entity, although the depersonalization may be sufficiently prominent to dominate thoroughly the psychiatric picture. A feeling of unreality may persist for a long time, and the patient may describe himself as "walking death" or a "living shadow." On the other hand, the feeling may alternate with reality in veritable waves, registering the change thirty or forty times within an hour.
The distinguishing characteristic of the symptoms in the syndrome of the feeling
OBERNDORF CP. FEELING OF UNREALITY. Arch NeurPsych. 1936;36(2):322–330. doi:10.1001/archneurpsyc.1936.02260080094005
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