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Dissociative Disorders

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- Annex

Annex: Dissociative Disorders – DSM-5 and ICD-11 Criteria

Table 1: DSM-5 Dissociative Disorders (core criteria, summarized)

 1. Dissociative Identity Disorder (DID)  Code 300.14

  • Disruption of identity with two or more distinct personality states (in some cultures described as possession).
  • Discontinuity in sense of self and agency, with alterations in affect, behaviour, consciousness, memory, perception, cognition, or motor function.
  • Recurrent gaps in recall of everyday events, important personal information, or traumatic events, inconsistent with ordinary forgetting.
  • Symptoms cause clinically significant distress or impairment.
  • Not a broadly accepted cultural/religious practice.
  • Not attributable to a substance or another medical condition.

2. Dissociative Amnesia   Code 300.12

  • Inability to recall important autobiographical information, usually traumatic or stressful, inconsistent with ordinary forgetting.
  • Disturbance causes clinically significant distress or impairment.
  • Not due to substances or medical/neurological conditions.
  • Not better explained by DID, PTSD, acute stress disorder, somatic symptom disorder, or neurocognitive disorder.
  • Specifier: with dissociative fugue – purposeful travel or wandering associated with amnesia.

3. Depersonalization/Derealization Disorder Code 300.6

  • Persistent or recurrent experiences of:
    • Depersonalization: feeling detached from one’s mental processes or body.
    • Derealization: experiences of unreality or detachment from surroundings.
  • Reality testing remains intact.
  • Symptoms cause clinically significant distress or impairment.
  • Not due to substances, medical conditions, or other mental disorders.

4. Other Specified Dissociative Disorder (OSDD) Code 300.16

  • Symptoms cause significant distress/impairment but do not fully meet criteria for a specific dissociative disorder.
  • Clinician specifies the presentation (e.g., chronic mixed dissociative symptoms, identity disturbance without overt switching, dissociative trance).

5. Unspecified Dissociative Disorder (UDD) Code 300.15

  • Symptoms characteristic of a dissociative disorder that cause distress/impairment but do not meet full criteria for a specific disorder.
  • Used when clinician chooses not to specify, or insufficient information is available.

 

Adapted from: American Psychiatric Association (8).

Table 2: ICD-11 Dissociative Disorders (6B codes)

6B64 Dissociative Identity Disorder

  • Characterized by two or more distinct personality states with discontinuity in sense of self and agency.
  • Recurrent episodes of amnesia for everyday events, personal information, or traumatic events.
  • Not explained by cultural or religious practices.
  • Causes significant distress or impairment.

6B61 Dissociative Amnesia

  • Inability to recall important autobiographical information, usually of a traumatic or stressful nature, inconsistent with ordinary forgetting.
  • May present as localized, selective, or generalized amnesia.
  • May include purposeful travel or wandering (fugue).
  • Causes significant distress or impairment, not attributable to substances or neurological/medical conditions.

6B66 Depersonalization-Derealization Disorder

  • Persistent or recurrent experiences of depersonalization, derealization, or both.
  • Reality testing remains intact.
  • Causes significant distress or impairment.
  • Not explained by another medical or mental condition.

6B60 Dissociative Neurological Symptom Disorder (Functional Neurological Disorder)

  • Altered voluntary motor or sensory function (e.g., paralysis, convulsions, anesthesia, sensory loss) inconsistent with recognized neurological or medical disease.
  • Symptoms not explained by another mental/medical disorder.
  • Causes significant distress, impairment, or warrants medical evaluation.

6B6Y Other Specified Dissociative Disorder

  • Clinical presentations where dissociative symptoms cause distress/impairment but do not fully meet criteria for another specific disorder.
  • Clinician specifies the reason (e.g., partial symptoms).

6B6Z Dissociative Disorder, unspecified

  • Dissociative symptoms causing significant distress/impairment but insufficient information to make a more specific diagnosis.

6B62      Trance Disorder

·   Characterized by trance states in which there is marked alteration in the individual's state of consciousness or a loss of the individual's customary sense of personal identity, in which the individual experiences a narrowing of immediate surroundings or unusual narrowing or selective focus on environmental stimuli. The trance state is involuntary and unwanted and is not accepted as a part of collective or religious practice.

Adapted from: International Classification of Diseases 11th Revision (1).