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ICD-10 - Dissociative Disorders

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[From World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Copyright, World Health Organization, Geneva, 1993.] ...

G1. There must be no evidence of a physical disorder that can explain the characteristic symptoms of this disorder (although physical disorders may be present that give rise to other symptoms).
G2. There are convincing associations in time between the onset of symptoms of the disorder and stressful events, problems, or needs.
Dissociative amnesia

  1. The general criteria for dissociative disorder must be met.
  2. There must be amnesia, partial or complete, for recent events or problems that were or still are traumatic or stressful.
  3. The amnesia is too extensive and persistent to be explained by ordinary forgetfulness (although its depth and extent may vary from one assessment to the next) or by intentional simulation.

Dissociative fugue

  1. The general criteria for dissociative disorder must be met.
  2. The individual undertakes an unexpected yet organized journey away from home or from the ordinary places of work and social activities, during which self-care is largely maintained.
  3. There is amnesia, partial or complete, for the journey, which also meets Criterion C for dissociative amnesia.

Dissociative stupor

  1. The general criteria for dissociative disorder must be met.
  2. There is profound diminution or absence of voluntary movements and speech and of normal responsiveness to light, noise, and touch.
  3. Normal muscle tone, static posture, and breathing (and often limited coordinated eye movements) are maintained.

Trance and possession disorders

  1. The general criteria for dissociative disorder must be met.
  2. Either of the following must be present:
    1. Trance. There is temporary alteration of the state of consciousness, shown by any two of the following:
      1. Loss of the usual sense of personal identity
      2. Narrowing of awareness of immediate surroundings or unusually narrow and selective focusing on environmental stimuli
      3. Limitation of movements, postures, and speech to repetition of a small repertoire
    2. Possession disorder. The individual is convinced that he or she has been taken over by a spirit, power, deity, or other person.
  3. (1) and (2) of Criterion B must be unwanted and troublesome, occurring outside, or being a prolongation of, similar states in religious or other culturally accepted situations.
  4. Most commonly used exclusion clause. The disorder does not occur at the same time as schizophrenia or related disorders, or mood (affective) disorders with hallucinations or delusions.

Dissociative motor disorders

  1. The general criteria for dissociative disorder must be met.
  2. Either of the following must be present:
    1. Complete or partial loss of the ability to perform movements that are normally under voluntary control (including speech)
    2. Various or variable degrees of incoordination or ataxia, or inability to stand unaided

Dissociative convulsions

  1. The general criteria for dissociative disorder must be met.
  2. The individual exhibits sudden and unexpected spasmodic movements, closely resembling any of the varieties of epileptic seizure but not followed by loss of consciousness.
  3. The symptoms in Criterion B are not accompanied by tongue biting, serious bruising or laceration due to falling, or urinary incontinence.

Dissociative anesthesia and sensory loss

  1. The general criteria for dissociative disorder must be met.
  2. Either of the following must be present:
    1. Partial or complete loss of any or all of the normal cutaneous sensations over part or all of the body (specify: touch, pin prick, vibration, heat, cold)
    2. Partial or complete loss of vision, hearing, or smell (specify)

Mixed dissociative (conversion) disorders
Other dissociative (conversion) disorders
This residual code may be used to indicate other dissociative and conversion states that meet Criteria G1 and G2 for dissociative (conversion) disorders but do not meet the criteria for the dissociative disorders listed previously.
Ganser syndrome (approximate answers)
Multiple personality disorder

  1. Two or more distinct personalities exist within the individual, only one being evident at a time.
  2. Each personality has its own memories, preferences, and behavior patterns and, at some time (and recurrently), takes full control of the individual's behavior.
  3. There is inability to recall important personal information, which is too extensive to be explained by ordinary forgetfulness.
  4. The symptoms are not due to organic mental disorders (e.g., in epileptic disorders) or psychoactive substance-related disorders (e.g., intoxication or withdrawal).
    Transient dissociative (conversion) disorders occurring in childhood and adolescence
    Other specified dissociative (conversion) disorders
    Specific research criteria are not given for all disorders mentioned previously, because these other dissociative states are rare and not well described. Research workers studying these conditions in detail should specify their own criteria according to the purpose of their studies.
    Dissociative (conversion) disorder, unspecified



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