The key diagnostic criteria for Dissociative Identity Disorder (DID) according to the DSM-5 include:
- Presence of two or more distinct personality states or identities, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.
- Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.
- The symptoms cause clinically significant distress or impairment
- The disturbance is not a normal part of broadly accepted cultural or religious practice.
- The symptoms are not attributable to the physiological effects of a substance or another medical condition.
These criteria emphasize the fragmentation of identity and memory disruptions as core features of DID, reflecting the complex dissociative processes involved Spiegel et al. 2011. The UK clinical context aligns with this framework, highlighting the importance of careful differential diagnosis to exclude other psychiatric or neurological conditions and the need for thorough clinical assessment to identify the characteristic identity alterations and amnesic episodes NICE NG116.
Recent literature further elaborates on the etiology and diagnostic challenges, noting that DID often arises in the context of severe trauma and that the distinct identities may serve as coping mechanisms Saxena et al. 2023. This supports the DSM-5 criteria’s focus on dissociative amnesia and identity disruption as central to diagnosis, while also underscoring the importance of a trauma-informed approach in clinical practice.
Key References
- NG116 - Post-traumatic stress disorder
- CG128 - Autism spectrum disorder in under 19s: recognition, referral and diagnosis
- CG78 - Borderline personality disorder: recognition and management
- (Spiegel et al., 2011): Dissociative disorders in DSM-5.
- (Saxena et al., 2023): Multiple Personality Disorder or Dissociative Identity Disorder: Etiology, Diagnosis, and Management.