Which statement best describes the core features of Depersonalization-Derealization Disorder?

• A. Delusions of unreality unrelated to self or surroundings
• B. Intact reality testing despite mild symptoms
• C. Memory loss with confusion about identity
• D. Recurrent or persistent experiences of unreality or detachment from self (depersonalization) or surroundings (derealization) with intact reality testing

Answer: (D)

Depersonalization-Derealization Disorder is defined by recurrent or persistent experiences of being detached from oneself (depersonalization) or from the surrounding world (derealization), while reality testing remains intact. In other words, people feel unreal or detached, but they recognize that these experiences aren’t real and that the world hasn’t actually changed. These episodes can cause significant distress or impairment, yet they aren’t due to a psychotic belief, a medical condition, or substance use. That combination—the presence of depersonalization or derealization experiences with preserved reality testing—best describes the disorder. Delusions would involve a false belief held with conviction and impaired reality testing; noting only mild symptoms misses the defining perceptual disturbances; and memory loss with identity confusion points to other dissociative conditions, not this one.