Yes, Other Specified Personality Disorder (OSPD) is a recognized diagnosis
Other Specified Personality Disorder is a legitimate diagnostic category in the DSM-5, used when personality pathology exists but doesn't meet full criteria for a specific personality disorder, or when the clinician chooses to specify the reason the presentation doesn't meet criteria.
Understanding the Diagnostic Context
The term "Other Specified Personality Disorder" exists within the broader context of how personality disorders are classified. However, it's critical to understand that the ICD-11 (implemented in 2022) has fundamentally restructured personality disorder diagnosis by eliminating discrete personality disorder categories entirely 1.
ICD-11 Approach (Current International Standard)
In ICD-11, the multiple distinct personality disorder categories from ICD-10 were replaced with a single unified personality disorder diagnosis characterized by:
- Problems in functioning of aspects of the self (e.g., identity)
- Interpersonal dysfunction (e.g., managing conflict in relationships)
- Severity grading: mild, moderate, or severe
- Optional specification by maladaptive personality traits (negative affectivity, detachment, dissociality, disinhibition, anankastia, and borderline pattern) 1
This change occurred because the division of personality disorders into discrete categories was not empirically based, and a large proportion of patients simultaneously fulfilled criteria for multiple personality disorders 1.
DSM-5 Approach (U.S. Standard)
The DSM-5 maintains categorical personality disorders but includes "Other Specified Personality Disorder" as a diagnostic option when:
- The personality pattern causes clinically significant distress or impairment
- The presentation doesn't fit cleanly into one of the defined personality disorder categories
- The clinician wants to communicate the specific reason criteria aren't met
Critical Caveat: Context Matters
Be extremely cautious about the specific context in which "Other Specified" diagnoses are being used. The research evidence reveals significant concerns about "Other Specified Paraphilic Disorder" (a completely different diagnostic category) being misused in forensic settings, particularly in sexually violent predator evaluations, where it demonstrates poor interrater reliability (kappa = 0.21) and lacks scientific validity 2, 3, 4. This forensic misuse should not be confused with the legitimate use of Other Specified Personality Disorder in clinical practice.
Clinical Application
When using Other Specified Personality Disorder:
- Document the specific personality features present
- Explain why full criteria for a specific personality disorder aren't met
- Consider whether the ICD-11 dimensional approach might be more clinically useful
- Ensure the diagnosis serves a clinical purpose rather than administrative convenience
The diagnosis is valid and recognized, but clinicians should be moving toward the more empirically-supported dimensional approach of ICD-11 rather than relying heavily on "other specified" categories that may reflect diagnostic uncertainty 1.