Other and unspecified dissociative disorders
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Other specified dissociative disorder (OSDD) and Unspecified dissociative disorder are two diagnostic categories for dissociative disorders (DDs) defined in the fifth edition (DSM-5) of the Diagnostic and Statistical Manual of Mental Disorders for individuals experiencing pathological dissociation that does not meet the full criteria for any specific dissociative disorder, such as dissociative identity disorder or depersonalization-derealization disorder.[1] These two categories replaced the earlier Dissociative Disorder Not Otherwise Specified (DDNOS) used in the DSM-IV and DSM-IV-TR.
OSDD is used when the clinician can identify the reason why the presentation doesn’t fit a specific diagnosis, such as mixed dissociative symptoms or identity disturbance following coercive persuasion. A diagnosis of unspecified dissociative disorder is given when this reason is not specified.[1]
Like other dissociative disorders, these conditions are often trauma-related[2] and may co-occur with other mental health diagnoses.[3][4] Dissociative conditions appear to respond well to psychotherapy. There are currently no drugs available that treat dissociative symptoms directly.[5][6]
Other specified dissociative disorder
Summarize
Perspective
Other specified dissociative disorder (OSDD) is a mental health diagnosis for pathological dissociation that matches the DSM-5 criteria for a dissociative disorder, but does not fit the full criteria for any of the dissociative disorders, such as dissociative identity disorder, dissociative amnesia, and depersonalization/derealization disorder. Additionally, a diagnosis requires that reasons why the presentation does not fit specific diagnoses are specified.[1] The ICD-10 diagnosis which includes the DSM-5's OSDD (F44.89)[1] is "Other dissociative [conversion] disorders" (F44.8).[7] The ICD-11 includes the diagnosis "Other specified dissociative disorders" (6B6Y ).
There are currently four examples of OSDD given in the DSM. Examples of OSDD presentations include ongoing or recurring dissociative symptoms that involve shifts in identity or self-perception without full amnesia, disruptions in identity following sustained psychological manipulation or coercive persuasion, brief dissociative states in response to acute stressors, and episodes of trance-like detachment marked by unresponsiveness and altered awareness outside of cultural norms.[1]
When diagnosing OSDD, a clinician specifies more detail on the diagnosis in the client's file. The DSM-5 gives the example of "recording 'other specified dissociative disorder' followed by the specific reason (e.g., 'dissociative trance')."[1] A common misconception with the examples listed in the DSM is that they are four "types" of OSDD,[citation needed] but the DSM never actually names the examples as "types" of OSDD; rather, it lists them as examples of what the clinician could specify in the client's file.[1]
OSDD is the most common dissociative disorder and is diagnosed in 40% of dissociative disorder cases.[8] It is often co-morbid with other mental illnesses such as complex posttraumatic stress disorder, major depressive disorder, generalized anxiety disorder, personality disorders, substance use disorders, and eating disorders.
Unspecified dissociative disorder
A diagnosis of Unspecified dissociative disorder is given when the clinician does not give a reason for criteria for a specific dissociative disorder not being met. The DSM-5 gives the example of "insufficient information to make a more specific diagnosis (e.g., in emergency room settings)" as a reason for why this might be the case.[1] The ICD-10 contains the similarly named diagnosis Dissociative [conversion] disorder, unspecified (F44.9),[7] and the ICD-11 contains Dissociative disorders, unspecified (6B6Z ).
Dissociative disorder not otherwise specified
Summarize
Perspective
| Dissociative disorder not otherwise specified | |
|---|---|
| Other names | Other dissociative and conversion disorders, partial dissociative identity disorder |
| Specialty | Psychiatry |
| Differential diagnosis | Conversion disorder (CD)/Functional neurologic symptom disorder (FNsD), Dissociative identity disorder, Depersonalization-derealization disorder, Borderline personality disorder, Post-traumatic stress disorder, Unspecified dissociative disorder |
Dissociative disorder not otherwise specified (DDNOS) was a mental health diagnosis for pathological dissociation that matched the DSM-IV criteria for a dissociative disorder, but did not fit the full criteria for any of the specific dissociative disorders.[9]
Diagnosis
Several examples of how DDNOS can manifest are provided in the DSM-IV.[9] These examples, due to being numbered have been used as distinct subtypes of DDNOS in the following manner:[10]
- DDNOS 1 – DID but switching not observed by clinician, or amnesia for the significant past but not everyday life.[11]
- DDNOS 1a – Like DID but with less distinct parts/no alters. Alters may be emotional fragments or the same individual at different ages. Can experience emotional amnesia rather than physical amnesia.[11][12]
- DDNOS 1b – Like DID but no amnesia between alters.[11][12]
- DDNOS 2 – Derealization without depersonalization.[11]
- DDNOS 3,4,5,etc. – DID but with specific symptoms. Eg) Identity change due to brainwashing, acute dissociative reaction, dissociative trance, Ganser Syndrome.[11]
- Dissociative disorder with unclear symptoms.[11]
See also
References
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