Other specified dissociative disorder (OSDD) is a mental health diagnosis for pathological dissociation that matches the

DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatric ...

criteria for a

dissociative disorder Dissociative disorders (DD) are conditions that involve disruptions or breakdowns of memory, awareness, identity, or perception. People with dissociative disorders use dissociation as a defense mechanism, pathologically and involuntarily. The ind ...

, but does not fit the full criteria for any of the specifically identified subtypes, which include

dissociative identity disorder Dissociative identity disorder (DID), better known as multiple personality disorder or multiple personality syndrome, is a mental disorder characterized by the presence of at least two distinct and relatively enduring personality states. The di ...

dissociative amnesia Psychogenic amnesia or dissociative amnesia is a memory disorder characterized by sudden retrograde episodic memory loss, said to occur for a period of time ranging from hours to years to decades. More recently, "dissociative amnesia" has been d ...

, and depersonalization/derealization disorder, and the reasons why the previous diagnoses were not met are specified. "Unspecified dissociative disorder" is given when the clinician does not give a reason. The

International Statistical Classification of Diseases and Related Health Problems The International Classification of Diseases (ICD) is a globally used diagnostic tool for epidemiology, health management and clinical purposes. The ICD is maintained by the World Health Organization (WHO), which is the directing and coordinating ...

(ICD-10) refers to the diagnosis as "Other dissociative and conversion disorders". Under the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), it was known as "Dissociative disorder not otherwise specified" (DDNOS). Examples of OSDD include chronic and recurrent syndromes of mixed dissociative symptoms, identity disturbance due to prolonged and intense

coercive persuasion Brainwashing (also known as mind control, menticide, coercive persuasion, thought control, thought reform, and forced re-education) is the concept that the human mind can be altered or controlled by certain psychological techniques. Brainwashin ...

, disorders similar to dissociative identity disorder, acute dissociative reactions to stressful events, and dissociative trance. OSDD is the most common dissociative disorder and is diagnosed in 40% of dissociative disorder cases. It is often co-morbid with other mental illnesses such as

complex posttraumatic stress disorder Complex post-traumatic stress disorder (C-PTSD; also known as complex trauma disorder) is a psychological disorder that is theorized to develop in response to exposure to a series of traumatic events in a context in which the individual perceive ...

major depressive disorder Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Introdu ...

generalized anxiety disorder Generalized anxiety disorder (GAD) is a mental and behavioral disorder, specifically an anxiety disorder characterized by excessive, uncontrollable and often irrational worry about events or activities. Worry often interferes with daily function ...

personality disorders Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture ...

substance use disorder Substance use disorder (SUD) is the persistent use of drugs (including alcohol) despite substantial harm and adverse consequences as a result of their use. Substance use disorders are characterized by an array of mental/emotional, physical, and ...

s, and

eating disorders An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's physical or mental health. Only one eating disorder can be diagnosed at a given time. Types of eating disorders include binge eating ...

. There are currently no available drugs that treat dissociative symptoms directly; however, dissociative conditions appear to respond well to psychotherapy.

Evolution

OSDD was officially adopted in the DSM-V, which was published in 2013, alongside Unspecified Dissociative Disorder to replace DDNOS.

Criteria

There are currently four examples of OSDD given in the DSM. OSDD is a "catch-all" category for any presentation that is abnormal but does not meet the diagnostic criteria for any of the dissociative disorders, and therefore the examples given are not the only presentations of OSDD possible. OSDD is only diagnosed when it is known that another dissociative disorder is not present; if the diagnosis is still being clarified, or if there is not enough time to make an informed diagnosis (such as in an emergency room setting), a diagnosis of

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 specifically identifie ...

may be given. It is worth noting that a person will not be diagnosed with "OSDD type 4" (for example); instead they will simply be diagnosed with OSDD. The diagnosing clinician may specify in the client's file that the diagnosis is "OSDD (dissociative trance)", but in general the simple diagnosis of OSDD will be given.

OSDD type 1

OSDD-1 is diagnosed when a person is experiencing sub-threshold dissociative identity disorder (DID). The DSM states that "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". The

ICD-11 The ICD-11 is the eleventh revision of the International Classification of Diseases (ICD). It replaces the ICD-10 as the global standard for recording health information and causes of death. The ICD is developed and annually updated by the World H ...

describes OSDD-1 as "Partial dissociative identity disorder".

OSDD type 2

OSDD-2 describes a dissociative identity disturbance caused by "prolonged and intense coercive persuasion". The DSM gives the examples of "

brainwashing Brainwashing (also known as mind control, menticide, coercive persuasion, thought control, thought reform, and forced re-education) is the concept that the human mind can be altered or controlled by certain psychological techniques. Brainwash ...

, thought reform,

indoctrination Indoctrination is the process of inculcating a person with ideas, attitudes, cognitive strategies or professional methodologies (see doctrine). Humans are a social animal species inescapably shaped by cultural context, and thus some degree ...

while captive,

torture Torture is the deliberate infliction of severe pain or suffering on a person for reasons such as punishment, extracting a confession, interrogation for information, or intimidating third parties. Some definitions are restricted to acts c ...

, long-term political imprisonment, recruitment by

sect A sect is a subgroup of a religious, political, or philosophical belief system, usually an offshoot of a larger group. Although the term was originally a classification for religious separated groups, it can now refer to any organization that b ...

cult In modern English, ''cult'' is usually a pejorative term for a social group that is defined by its unusual religious, spiritual, or philosophical beliefs and rituals, or its common interest in a particular personality, object, or goal. This ...

s or by terror organizations." People with OSDD-2, as a result, experience distressing changes to and/or questioning of their identity.

OSDD type 3

OSDD-3 is diagnosed when a person experiences acute dissociative reactions to stressful events. These reactions last anywhere from a few hours to weeks, but typically less than a month. The dissociative conditions are characterised by "constriction of consciousness", including "depersonalization; derealization; perceptual disturbances (e.g., time slowing,

macropsia Macropsia is a neurological condition affecting human visual perception, in which objects within an affected section of the visual field appear larger than normal, causing the person to feel smaller than they actually are. Macropsia, along with its ...

); micro-amnesias; transient stupor; and/or alterations in sensory-motor functioning (e.g., analgesia,

paralysis Paralysis (also known as plegia) is a loss of motor function in one or more muscles. Paralysis can also be accompanied by a loss of feeling (sensory loss) in the affected area if there is sensory damage. In the United States, roughly 1 in 50 ...

)."

OSDD type 4

OSDD-4 is characterised by a dissociative trance; "an acute narrowing or complete loss of awareness of immediate surroundings that manifests as profound unresponsiveness or insensitivity to environmental stimuli." The DSM specifies that "The dissociative trance is not a normal part of a broadly accepted collective cultural or religious practice". In the ICD-11, this condition warrants a separate diagnosis of Trance disorder.

References

{{Reflist Dissociative disorders