Other specified dissociative disorder (OSDD) andUnspecified dissociative disorder are two diagnostic categories fordissociative disorders (DDs) defined in thefifth edition (DSM-5) of theDiagnostic and Statistical Manual of Mental Disorders for individuals experiencing pathological dissociation that does not meet the full criteria for any specific dissociative disorder, such asdissociative identity disorder ordepersonalization-derealization disorder.[1] These two categories replaced the earlierDissociative Disorder Not Otherwise Specified (DDNOS) used in theDSM-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 oridentity disturbance followingcoercive 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 topsychotherapy. There are currently no drugs available that treatdissociative symptoms directly.[5][6]
| Other specified dissociative disorder | |
|---|---|
| Specialty | Psychiatry |
| Symptoms | Various dissociative symptoms which do not align well with specific dissociative disorders |
| Causes | Trauma |
Other specified dissociative disorder (OSDD) is a mental health diagnosis for pathological dissociation that matches theDSM-5 criteria for adissociative disorder, but does not fit the full criteria for any of the dissociative disorders, such asdissociative identity disorder,dissociative amnesia, anddepersonalization/derealization disorder. Additionally, a diagnosis requires that reasons why the presentation does not fit specific diagnoses are specified.[1] TheICD-10 diagnosis which includes the DSM-5's OSDD (F44.89)[1] is "Other dissociative [conversion] disorders" (F44.8).[7] TheICD-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 fullamnesia, disruptions in identity following sustainedpsychological manipulation orcoercive persuasion, brief dissociative states in response to acute stressors, and episodes oftrance-like detachment marked by unresponsiveness and altered awareness outside ofcultural 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 ascomplex posttraumatic stress disorder,major depressive disorder,generalized anxiety disorder,personality disorders,substance use disorders, andeating disorders.
A diagnosis ofUnspecified 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 diagnosisDissociative [conversion] disorder, unspecified (F44.9),[7] and the ICD-11 containsDissociative disorders, unspecified (6B6Z).
| 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 disordernot 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]
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]
This category is included for disorders in which the predominant feature is a dissociative symptom (i.e., a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment) that does not meet the criteria for any specific Dissociative Disorder. Examples include 1. Clinical presentations similar to Dissociative Identity Disorder that fail to meet full criteria for this disorder. Examples include presentations in which a) there are not two or more distinct personality states, or b) amnesia for important personal information does not occur.
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