This website is dedicated to providing information and resources surrounding the topic of Dissociative Disorders, with a focus on mixed dissociative symptoms as seen in Dissociative Identity Disorder, Partial Dissociative Identity Disorder, and Other Specified Dissociative Disorder Subtype 1.
In the psychiatric field there are two main resources used for the classification of mental disorders, the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD). The DSM is published by the American Psychiatric Association (APA), and is used in the United States, whilst the ICD is published by the World Health Organization (WHO), and is used in most other countries. As of last update the latest version of the DSM is the DSM-V-TR1, and the latest version of the ICD is the ICD-11.
The Diagnostic and Statistical Manual of Mental Disorders (DSM)
The DSM-V defines dissociative disorders as being “characterized by a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior”.
The diagnosis of OSDD-1 is made when a patient is experiencing chronic and recurrent syndromes of mixed dissociative symptoms, that do not fully meet the criteria of Dissociative Identity Disorder (DID).
The criteria of DID as per the DSM-V are as follows:
– Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.
– Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting
– The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
– The disturbance is not a normal part of a broadly accepted cultural or religious practice.
Note: In children, the symptoms are not better explained by imaginary playmates or other fantasy play
– The symptoms are not attributable to the physiological effects of a substance (e.g., blackouts or chaotic behavior during alcohol intoxication) or another medical condition (e.g., complex partial seizures).
For the sake of simplicity, these can roughly be simplified down to the following
– Disruption of identity with a marked discontinuity in sense of self and agency, that is accompanied with alterations in affect.
This can be further simplified to being the presence of distinct alternate personality states, known as “alters”.
– The presence of amnesia
– The symptoms cause distress or impairment
– The disturbance is not related to cultural or religious practices
– The symptoms are not better explained by something else
The description of OSDD-1 as per the DSM-V is as follows
– Chronic and recurrent syndromes of mixed dissociative symptoms: This category includes identity disturbance associated with less-than-marked discontinuities in sense of self and agency, or alterations of identity or episodes of possession in an individual who reports no dissociative amnesia.
Prior to the DSM-V, the DSM-IV described this phenomenon under it’s Dissociative Disorder Not Otherwise Specified classification, and designated subclassifications of 1a and 1b based on the DID criteria that the patient failed to meet (e.g. a patient not exhibiting the amnesia required for the B criteria of DID would be diagnosed with DDNOS-1b), whilst the DSM-V does not specify these subclassifications, it does expect the diagnostician to provide the reasoning the patient fits the OSDD diagnosis, as such some clinicians continue to utilise the 1a/b classifications in situations where a patient fits the traditional model of DDNOS, and many individuals within the community continue to use these classifications to identify their experiences, however there is a spectrum of experiences that can fall under OSDD-1 that may not fit neatly into this model.
The International Classification of Diseases (ICD)
In the International Classification of Diseases (ICD-11), OSDD does not have specific number subtypes, and is an “other specified” residual category for dissociative disorders. The ICD-11 also includes the diagnosis of Partial Dissociative Identity Disorder (P-DID), which encompasses some, but not all, experiences that could have been considered OSDD-1 under the DSM-V.
The full ICD-11 can be browsed freely online here, however for ease of reading the essential features listed for OSDD have been copied below.
– The presentation is characterized by symptoms that share primary clinical features with other Dissociative Disorders (i.e., involuntary disruption or discontinuity in the normal integration of one or more of the following: identity, sensations, perceptions, affects, thoughts, memories, control over bodily movements, or behaviour).
– The symptoms do not fulfil the diagnostic requirements of any of the other disorders in the grouping of Dissociative Disorders.
– The symptoms are not better accounted for by another mental disorder (e.g., Post-Traumatic Stress Disorder, Complex Post-Traumatic Stress Disorder, Schizophrenia, Bipolar Disorders).
– The symptoms are involuntary and unwanted and are not accepted as a part of a collective cultural or religious practice.
– The symptoms are not due to the effects of a substance or medication on the central nervous system, including withdrawal effects (e.g., blackouts or chaotic behaviour during substance intoxication), and are not due to a Disease of the Nervous System (e.g., complex partial seizures), a Sleep-Wake disorder (e.g., symptoms occur during hypnagogic or hypnopompic states), head trauma, or another medical condition.
– The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning. If functioning is maintained, it is only through significant additional effort.
In future updates pages dedicated to the diagnostic criteria of OSDD-1 and P-DID will be added to this website, however for now the above information should be sufficient to provide a basic understanding of the differences between the two diagnoses.
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