- Annex
Annex: Dissociative
Disorders – DSM-5 and ICD-11 Criteria
Table 1: DSM-5
Dissociative Disorders (core criteria, summarized)
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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.
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Adapted from: American Psychiatric Association (8).
Table 2: ICD-11
Dissociative Disorders (6B codes)
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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.
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Adapted from: International Classification of
Diseases 11th Revision (1).