[[File:DSM-IV to DSM-V DDNOS to OSDD.png|thumb|266x266px|Visualization of the transition from DD-NOS in the DSM-IV-TR to diagnoses in the DSM-5.]]

'''Other specified dissociative disorder''' ('''OSDD''') and '''Unspecified dissociative disorder''' ('''UDD''') are two diagnostic categories for [[dissociative disorder]]s (DDs) defined in the [[DSM-5|fifth edition]] (DSM-5) of the ''[[Diagnostic and Statistical Manual of Mental Disorders]]'' for individuals experiencing pathological dissociation that does not meet the full criteria for any specific dissociative disorder, such as [[dissociative identity disorder]] or [[depersonalization-derealization disorder]].<ref name="mw-2013" /> These two categories replaced the earlier '''Dissociative Disorder Not Otherwise Specified''' ('''DDNOS''') used in the [[DSM-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 or [[identity disturbance]] following [[coercive persuasion]]. A diagnosis of unspecified dissociative disorder is given when this reason is not specified.<ref name="mw-2013" />

Like other dissociative disorders, these conditions are often trauma-related<ref>{{Cite journal |last1=Boyer |first1=Stacey M. |last2=Caplan |first2=Jennifer E. |last3=Edwards |first3=Lisa K. |date=2022-05-31 |title=Trauma-Related Dissociation and the Dissociative Disorders:: Neglected Symptoms with Severe Public Health Consequences |journal=Delaware Journal of Public Health |volume=8 |issue=2 |pages=78–84 |doi=10.32481/djph.2022.05.010 |issn=2639-6378 |pmc=9162402 |pmid=35692991}}</ref> and may co-occur with other mental health diagnoses.<ref>{{Cite journal |last1=Rodewald |first1=Frauke |last2=Wilhelm-Göling |first2=Claudia |last3=Emrich |first3=Hinderk M. |last4=Reddemann |first4=Luise |last5=Gast |first5=Ursula |date=February 2011 |title=Axis-I Comorbidity in Female Patients With Dissociative Identity Disorder and Dissociative Identity Disorder Not Otherwise Specified |url=https://journals.lww.com/00005053-201102000-00010 |journal=Journal of Nervous & Mental Disease |language=en |volume=199 |issue=2 |pages=122–131 |doi=10.1097/NMD.0b013e318208314e |issn=0022-3018|url-access=subscription }}</ref><ref>{{Cite journal |last=Temple |first=Melanie J. |date=January 2019 |title=Understanding, identifying and managing severe dissociative disorders in general psychiatric settings |url=https://www.cambridge.org/core/journals/bjpsych-advances/article/understanding-identifying-and-managing-severe-dissociative-disorders-in-general-psychiatric-settings/62CC0133915C7F47CDAFADC230EE5001 |journal=BJPsych Advances |language=en |volume=25 |issue=1 |pages=14–25 |doi=10.1192/bja.2018.54 |issn=2056-4678}}</ref> Dissociative conditions appear to respond well to [[psychotherapy]]. There are currently no drugs available that treat [[dissociative symptom]]s directly.<ref>{{Cite journal |last=Şar |first=Vedat |author-link=Vedat Şar |date=2014-12-28 |title=The Many Faces of Dissociation: Opportunities for Innovative Research in Psychiatry |journal=Clinical Psychopharmacology and Neuroscience |language=en |volume=12 |issue=3 |pages=171–179 |doi=10.9758/cpn.2014.12.3.171 |issn=1738-1088 |pmc=4293161 |pmid=25598819}}</ref><ref>{{Cite journal |last1=Brand |first1=Bethany |last2=Classen |first2=Catherine |last3=Lanins |first3=Ruth |last4=Loewenstein |first4=Richard |last5=McNary |first5=Scott |last6=Pain |first6=Claire |last7=Putnam |first7=Frank |date=June 2009 |title=A naturalistic study of dissociative identity disorder and dissociative disorder not otherwise specified patients treated by community clinicians. |url=https://psycnet.apa.org/doi/10.1037/a0016210 |journal=Psychological Trauma: Theory, Research, Practice, and Policy |language=en |volume=1 |issue=2 |pages=153–171 |doi=10.1037/a0016210 |issn=1942-969X |archive-url=https://web.archive.org/web/20250306104232/https://psycnet.apa.org/doi/10.1037/a0016210 |archive-date=2025-03-06 |url-access=subscription |access-date=2025-04-16 |url-status=live }}</ref>

== Other specified dissociative disorder == {{Infobox medical condition | name = 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 the [[DSM-5]] criteria for a [[dissociative disorder]], but does not fit the full criteria for any of the dissociative disorders, such as [[dissociative identity disorder]], [[dissociative amnesia]], and [[Depersonalization-derealization disorder|depersonalization/derealization disorder]]. Additionally, a diagnosis requires that reasons why the presentation does not fit specific diagnoses are specified.<ref name="mw-2013">{{Cite book |title=Diagnostic and statistical manual of mental disorders: DSM-5 |date=2013 |publisher=American Psychiatric Association |isbn=978-0-89042-554-1 |editor-last=American Psychiatric Association |edition=5th |location=Washington, D.C |pages=306–307 |editor-last2=American Psychiatric Association}}</ref> The [[ICD-10]] diagnosis which includes the DSM-5's OSDD ({{ICD10CM|F44.89}})<ref name="mw-2013" /> is "'''Other dissociative [conversion] disorders'''" ({{ICD10|F44.8}}).<ref name="Neurotic">{{Cite web |title=Neurotic, stress-related and somatoform disorders (F40-F48) |url=https://icd.who.int/browse10/2019/en#/F44.8 |access-date=2025-04-16 |website=ICD-10 Version:2019}}</ref> The [[ICD-11]] includes the diagnosis "'''Other specified dissociative disorders'''" ({{ICD11|6B6Y}}).

There are currently four examples of presentations of OSDD given in the DSM:

1. “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”<ref name="mw-2013" />

* OSDD-1 was previously known as DDNOS-1. While it was its own disorder, it was also was split into two further subcategories: 1a and 1b. DDNOS-1a was defined by disturbances associated with alterations of identity that were less marked than in [[dissociative identity disorder]] (DID). These parts could not be described as "distinct personality states"<sup>[1]</sup> or "[[Alters (dissociative identity disorder)|alters]]", for they lacked distinct differentiation. People often experienced these parts as different modes, versions, or ages of themselves, and [[amnesia]] was still present. Alternatively, DDNOS-1b was often considered functionally closer to DID,<ref name="Comparing OSDD" /> although individuals presented with little to no dissociative amnesia, less fragmented identities, and simpler internal organisation/[[Dissociative identity disorder#Validity disputed|splitting]] patterns. While OSDD now encompasses both of these diagnostic subcategories in a single, catch-all diagnosis, some individuals (especially in the DID/OSDD community) choose to continue using this terminology alongside the updated format, applying specifiers such as 1a or 1b to the OSDD label, even though they are now unofficial.

2. "Identity disturbance due to prolonged and intense [[coercive persuasion]]: Individuals who have been subjected to intense coercive persuasion (e.g., brainwashing, thought reform, indoctrination while captive, [[torture]], long-term [[political imprisonment]], recruitment by [[Sect|sects]]/[[Cult|cults]] or by terror organizations) may present with prolonged changes in, or conscious questioning of, their identity."<ref name="mw-2013" />

3. "Acute dissociative reactions to stressful events: This category is for acute, transient conditions that typically last less than 1 month, and sometimes only a few hours or days. These conditions are characterized by constriction of consciousness; [[depersonalization]]; [[derealization]]; [[Perceptual disturbance|perceptual disturbances]] (e.g., time slowing, [[macropsia]]); microamnesias; transient [[stupor]]; and/or alterations in sensory-motor functioning (e.g., analgesia, [[paralysis]])."<ref name="mw-2013" />

4. "Dissociative trance: This condition is characterized by an acute narrowing or complete loss of awareness of immediate surroundings that manifests as profound unresponsiveness or insensitivity to environmental stimuli. The unresponsiveness may be accompanied by minor [[Stereotypy|stereotyped behaviors]] (e.g., finger movements) of which the individual is unaware and/or that he or she cannot control, as well as transient paralysis or loss of consciousness. The [[Trance|dissociative trance]] is not a normal part of a broadly accepted collective [[Cultural norm|cultural or religious practice]]."<ref name="mw-2013" />

* Note: This may sound, and even look, similar to [[catatonia]] on the surface. However, this a dissociative disorder marked by temporary alterations in consciousness, identify and/or environment. Meanwhile, catatonia is neuropsychiatric condition often associated with [[psychosis]]. It frequently involves symptoms such as [[Catatonia#Signs and symptoms|posturing]], [[Catatonia#Signs and symptoms|mannerism]], [[echopraxia]] and/or stupor.

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')."<ref name="mw-2013" /> A common misconception with the examples listed in the DSM is that they are four "types" of OSDD,{{Citation needed|date=April 2025}} 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.<ref name="mw-2013" />

OSDD is the most common dissociative disorder and is diagnosed in 40% of dissociative disorder cases.<ref>{{Cite book |url=https://books.google.com/books?id=e-6WHeIf-dgC&pg=PR19 |title=Dissociation and the dissociative disorders: DSM-V and beyond |date=2009 |publisher=Routledge |isbn=978-0-415-95785-4 |editor-last=Dell |editor-first=Paul F. |location=New York |oclc=245509947 |editor-last2=O'Neil |editor-first2=John A. |archive-url=https://web.archive.org/web/20231102211736/https://books.google.com/books?id=e-6WHeIf-dgC&pg=PR19 |archive-date=2023-11-02}}</ref> It is often co-morbid with other mental illnesses such as [[complex posttraumatic stress disorder]], [[major depressive disorder]], [[generalized anxiety disorder]], [[personality disorders]], [[substance use disorder]]s, and [[eating disorders]].

== Unspecified dissociative disorder == A diagnosis of '''Unspecified 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.<ref name="mw-2013" /> The ICD-10 contains the similarly named diagnosis ''Dissociative [conversion] disorder, unspecified'' ({{ICD10|F44.9}}),<ref name="Neurotic" /> and the ICD-11 contains ''Dissociative disorders, unspecified'' ({{ICD11|6B6Z}}).

== Dissociative disorder not otherwise specified == {{Infobox medical condition | synonyms = Other dissociative and conversion disorders, partial dissociative identity disorder | name = Dissociative disorder not otherwise specified | field = [[Psychiatry]] | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = [[Conversion disorder|Conversion disorder (CD)/Functional neurologic symptom disorder (FNsD)]], [[Dissociative identity disorder]], [[Depersonalization-derealization disorder]], [[Borderline personality disorder]], [[Post-traumatic stress disorder]], [[Unspecified dissociative disorder]] | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }}'''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 specific dissociative disorders.<ref name="American Psychiatric Association-1998" />

=== Diagnosis === Several examples of how DDNOS can manifest are provided in the DSM-IV.<ref name="American Psychiatric Association-1998">{{Cite book |title=Diagnostic and statistical manual of mental disorders: DSM-IV ; includes ICD-9-CM codes effective 1. Oct. 96 |date=1998 |isbn=978-0-89042-061-4 |editor-last=American Psychiatric Association |edition=4. ed., 7. print |location=Washington, DC |pages=490–491 |quote=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.}}</ref> These examples, due to being numbered have been used as distinct subtypes of DDNOS in the following manner:<ref>Dell, Paul. (2009). The Long Struggle to Diagnose Multiple Personality Disorder (MPD) I. MPD</ref>

* DDNOS 1 – DID but switching not observed by clinician, or amnesia for the significant past but not everyday life.<ref name="traumadissociation.com-2015">{{Cite web|last=traumadissociation.com|date=2015|title=Other Specified Dissociative Disorder (DDNOS) – Types and DSM 5 criteria|url=http://traumadissociation.com/osdd|access-date=2020-07-29|website=Trauma dissociation}}</ref> * DDNOS 1a – Like DID but with less distinct parts/no alters. Alters may be emotional fragments or the same individual at different ages. Can experience emotional amnesia rather than physical amnesia.<ref name="traumadissociation.com-2015" /><ref name="Comparing OSDD">{{Cite web|title=Comparing OSDD-1 and DID|url=https://did-research.org/comorbid/dd/osdd_udd/did_osdd|access-date=2020-07-29|website=did-research.org}}</ref> * DDNOS 1b – Like DID but no amnesia between alters.<ref name="traumadissociation.com-2015" /><ref name="Comparing OSDD" /> * DDNOS 2 – Derealization without depersonalization.<ref name="traumadissociation.com-2015" /> * DDNOS 3, 4, 5, etc. – DID but with specific symptoms. Eg.: Identity change due to [[brainwashing]], acute dissociative reaction, dissociative trance, [[Ganser syndrome]].<ref name="traumadissociation.com-2015" /> * Dissociative disorder with unclear symptoms.<ref name="traumadissociation.com-2015" />

==See also== {{Portal|Psychology|Psychiatry}} * [[Conversion disorder]] * [[Dissociation (psychology)|Dissociation]] * [[Identity (social science)|Identity]] * [[Jamais vu]] * [[Posttraumatic stress disorder|Post-traumatic stress disorder (PTSD)]] * [[Complex post-traumatic stress disorder|Complex post-traumatic stress disorder (C-PTSD)]]

==References== {{reflist}}

[[Category:Dissociative disorders]]