The dividing line between DID and most cases of dissociative disorder not otherwise specified is arbitrary. This is certainly the view of a number of experts in the field.įor example Colin Ross (2007, p.142) says: But if up to three times as many people receive a diagnosis of OSDD/DDNOS compared to dissociative identity disorder, it would suggest that the definition of DID is too narrow. Certainly OSDD is supposed to be a ‘residual’ category to mop up the ‘few’ cases of dissociative disorders that do not meet the mainstream criteria. This of course begs the question of whether OSDD/DDNOS-1 and DID are in fact the same thing, and just different points on a spectrum, and whether the diagnostic criteria for DID are too tightly applied. The DSM-5 adds some detail to it, saying: ‘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.’ In other words, OSDD often presents as ‘not yet’ or ‘not quite’ DID – people who haven’t yet met the criteria for dissociative identity disorder but may well do so in the future, or people who have slightly atypical forms of DID, for example by not having amnesia. In practice, subtype 1 is much more common than the others. OSDD – ‘not quite’ dissociative identity disorder?
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Presentations in which symptoms characteristic of a dissociative disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate, but do not meet the full criteria for any of the disorders in the dissociative disorder class. And Spiegel et al (2011, p.838) state that ‘A review and analysis of OSDD concluded that the majority of OSDD cases are actually undiagnosed (or misdiagnosed) DID cases.’ So something is clearly going wrong.Īccording to the American Psychological Association, the predominant feature of OSDD is: Suzette Boon reports that OSDD ‘actually involves the majority of people who seek treatment for a dissociative disorder’ (Boon et al, p.10). This is a painful position to be in, and yet a variety of studies have regularly found that OSDD is either the most common or among the most common dissociative diagnoses: it is diagnosed, according to O’Neil et al (2008), in 40% of cases. People with OSDD often feel that their experience is not represented in books, articles and websites, that they are ‘less’ than people with DID – that not only are they ‘messed up’, as one person put it to me, but, ‘We’ve even messed up being messed up, by not having a proper condition.’ OSDD – the most common dissociative disorder? Many people with DID struggle with what their diagnosis means to them – they may resent it or disbelieve it, but there is at least some understanding, and an increasing amount of literature, on the nature of dissociative identity disorder. I’ll explain technically what OSDD is in a moment, but a quick (although inadequate) definition might be ‘dissociative identity disorder without distinct parts of the personality’. One of the many questions I frequently hear is about OSDD – other specified dissociative disorder. What is the difference between Dissociative Identity Disorder (DID) and Other Specified Dissociative Disorder (OSDD)? In this article we’re using the terms interchangeably whilst mainly using the term ‘OSDD’ for brevity.
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Note: DDNOS (dissociative disorder not otherwise specified) was renamed OSDD (other specified dissociative disorder) in the latest update to the psychiatric diagnostic manual, the DSM-5.
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