Original ArticleDepersonalization and Individualism: The Effect of Culture on Symptom Profiles in Panic DisorderSierra-Siegert, Mauricio MD, PhD; David, Anthony S. MDAuthor Information From the Depersonalization Research Unit, Institute of Psychiatry, King's College, London, UK. Send reprint requests to: Dr. Mauricio Sierra, Institute of Psychiatry, Section of Neuropsychiatry P068, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. E-mail: [email protected]. The Journal of Nervous and Mental Disease: December 2007 - Volume 195 - Issue 12 - p 989-995 doi: 10.1097/NMD.0b013e31815c19f7 Buy Metrics Abstract It has been proposed that highly individualistic cultures confer vulnerability to depersonalization. To test this idea, we carried out a comprehensive systematic review of published empirical studies on panic disorder, which reported the frequency of depersonalization/derealization during panic attacks. It was predicted that the frequency of depersonalization would be higher in Western cultures and that a significant correlation would be found between the frequency of depersonalization and individualism scores of the participant countries. As predicted, the frequency of depersonalization during panic was significantly lower in nonwestern countries. There was also a significant correlation between frequency of depersonalization and Individualism (ρ = 0.68, p < 0.0001), and between fears of losing control (ρ = 0.57, p = 0.005) and individualism. These findings are interpreted in light of recent studies suggesting that individualistic cultures are characterized by hypersensitivity to threat and by an external locus of control. Two features may be relevant in the genesis of depersonalization. © 2007 Lippincott Williams & Wilkins, Inc.