Other Specified Dissociative Disorder

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Other Specified Dissociative Disorder (OSDD) is a diagnosis within the DSM-V covering chronic & disruptive dissociative symptoms that do not fit the full criteria of any dissociative disorder. There are four listed example presentations of OSDD, but what qualifies as OSDD, or what OSDD can look like, is very diverse. OSDD is not diagnosed by subtypes, unlike its predecessor, DDNOS, and functions as a counterpart to Unspecified Dissociative Disorder.

DSM-5 Criteria
OSDD is any dissociative disorder that "cause[s] clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate" but does not meet the criteria for another dissociative disorder. A diagnosis is "other specified" because the diagnosing clinician specifies the reason that another disorder cannot be diagnosed. If the reason is unspecified, it is UDD.

DSM Examples
The four examples of broad OSDD presentations listed in the DSM-5 are as follows:


 * 1) Chronic and recurrent syndromes of mixed dissociative symptoms. This is noted as including identity disturbance with less notable changes in sense of self or agency and changes of identity with no reported dissociative amnesia, colloquially aligning with OSDD-1a and OSDD-1b.
 * 2) Identity disturbance due to prolonged and intense coercive persuasion. (See OSDD-2.)
 * 3) Acute dissociative reactions to stressful events. (See OSDD-3.)
 * 4) Dissociative trance. (See OSDD-4.)

OSDD-1
OSDD-1 systems lack some criterion of Dissociative Identity Disorder while still exhibiting alters. The most common types of this are OSDD-1a & OSDD-1b, missing the distinct alters and amnesic barriers respectively. However, OSDD-1 can include lacking both distinct alters & amnesia barriers, or other presentations of dissociative & disordered plurality.

OSDD-1a
OSDD-1a is missing the distinct alters found in DID, preventing a diagnosis. Alters are more blurry between one another and often have a core or shell identity. The identities with an OSDD-1a system may be very similar or diverse; one common presentation is one individual within different "modes" or ages, like an angry self, a 12-year-old self, etc. OSDD-1a is different than typical mood changes due to the amnesiac barriers between headmates.

OSDD-1b
OSDD-1b is missing the amnesia found in DID, preventing a diagnosis. There is no full amnesia ("blackouts") related to switching, but emotional amnesia may be present, as well as "grey-outs" in some cases. There may still be memory loss relating to trauma, but not between alters.

OSDD-2
OSDD-2 is characterized by identity disturbance due to brainwashing, torture, thought reform, or otherwise coercion-based dissociation. Examples include being indoctrinated into a cult, being held captive, etc.

OSDD-3
OSDD-3 is a transient diagnosis in which severe dissociative symptoms are present directly after a traumatic event. Depersonalization and derealization, amnesia, sudden loss of skills or coordination, etc and other signs usually last around a month. This diagnosis may last longer if this symptom (severe dissociation) occurs after every time a traumatic event happens to a patient.

OSDD-4
OSDD-4 is described as dissociative trances that do not have any other cause (including other conditions, spiritual practices, or drug use). Individuals slip in and out of these trance states, often unaware of their environment while in them, and may "come to" confused and missing memories of their time while dissociating.

History
In earlier iterations of the DSM, the term DDNOS (Dissociative Disorder Not Otherwise Specified) was the diagnosis assigned to dissociative disorders not fitting into identified disorders. This graphic explains the shift.

In the ICD-11, some equivalences to OSDD-1 are grouped with DID, while others fall under P-DID.

Related Terms
Other Specified Dissociative Disorder is one of multiple dissociative disorders listed within the DSM-V, including DID, UDD, and DPDR.

Systems that experience both a lack of distinct headmates and a lack of amnesia while still being plural may identify as a median system.

Only OSDD-1 is considered an inherently-plural disorder, but the others often intersect with other forms of plurality.