Examples of OSDD include chronic and recurrent syndromes of mixed dissociative symptoms, identity disturbance due to prolonged and intense coercive persuasion, disorders similar to dissociative identity disorder, acute dissociative reactions to stressful events, and dissociative trance.[1]
There are currently no available drugs that treat dissociative symptoms directly; however, dissociative conditions appear to respond well to psychotherapy.[5][6]
Evolution
OSDD was officially adopted in the DSM-V, which was published in 2013, alongside Unspecified Dissociative Disorder to replace DDNOS.[7]
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 may be given.
When being diagnosed with OSDD, a clinician may specify in the client's file more detail on the diagnosis. An example would be specifying "OSDD (dissociative trance)". A common misconception with the examples listed in the DSM is that they are four "types" of OSDD, but the DSM never actually names the examples as "types" of OSDD, rather lists them as examples of what the clinician could specify in the client's file.
Chronic and recurrent syndromes of mixed dissociative symptoms
The DSM states, "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".[1]
The ICD-11 describes this presentation as "Partial dissociative identity disorder".[8]
Identity disturbance due to prolonged and intense coercive persuasion
This category is used for acute dissociative episodes which may 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); micro-amnesias; transient stupor; and/or alterations in sensory-motor functioning (e.g., analgesia, paralysis)."[1]
Dissociative Trance
This category represents a dissociative trance; "an acute narrowing or complete loss of awareness of immediate surroundings that manifests as profound unresponsiveness or insensitivity to environmental stimuli."[1] 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.[8]
^Brand, Bethany; Classen, Catherine; Lanins, Ruth; Loewenstein, Richard; McNary, Scott; Pain, Claire; Putnam, Frank (2009). "A naturalistic study of dissociative identity disorder and dissociative disorder not otherwise specified patients treated by community clinicians". Psychological Trauma: Theory, Research, Practice, and Policy. 1 (2): 153–171. doi:10.1037/a0016210. ISSN1942-969X.