A clinical study of depersonalization-derealization in three young adults with homozygous sickle cell disease from Cameroon

Objective. - Depersonalization is described as commonplace and frequent in such varied registers as hysteria, phobic and anxiety disorders, dissociative disorders, depression, and psychosis. Howe-ver, very few papers give a clinical description in relation to more specifically somatic disorders such as sickle cell disease. This article describes the disorder in three young adults with homozygous sickle cell disease (SS) and attempts to decipher its psychopatho-logy and the unconscious processes responsible for its appearance in this context.Method. - The study is exploratory, descriptive, and qualitative. The method applied is the case study. The participants were selected in hospitals in the city of Yaounde in Cameroon. The data were collected using a clinical interview grid of the semi-directive type and then subjected to a content analysis.Results. - We identified depersonalization-derealization pheno-mena in these participants, correlated with "counter-elaborative" factors - an overly present feeling of "imminent death" - and an overly marked presence of visible signs of the disease. This is itself linked to a cultural environment marked by the scarcity of care adapted to the biopsychosocial needs of the affected popula-tions, and to psychopathological registers whose etiopathogenesis is aggravated by a vacillation of identity and an inflection of the libido in the transition from adolescence to adulthood.Discussion. - This thesis is inspired by Mayer Gross who suggested that depersonalization is an archaic response of the brain to survival situations.Conclusion. - These results suggest an understanding of deperso-nalization as a defensive attitude of the homozygous young adult faced with a reality judged as too threatening, regressive movement as a return to a primary phase of development where life was good.& COPY; 2023 Elsevier Masson SAS. All rights reserved.