Dissociative Identity Disorder in DSM-5
Yes, Dissociative Identity Disorder (DID) is officially recognized as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).
Diagnostic Status and Classification
Dissociative Identity Disorder (formerly known as Multiple Personality Disorder) is included in the DSM-5 as a formal psychiatric diagnosis 1, 2. The DSM-5 includes DID in a separate chapter dedicated to dissociative disorders 3, highlighting its distinct classification from other psychiatric conditions.
Diagnostic Criteria
According to the DSM-5-TR (Text Revision), DID is characterized by:
- The presence of two or more distinct personality states or identities
- Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events
- The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
- The disturbance is not a normal part of a broadly accepted cultural or religious practice
- The symptoms are not attributable to the physiological effects of a substance or another medical condition
Epidemiology and Clinical Significance
- DID affects approximately 1-1.5% of the general population 4
- Despite having a prevalence rate similar to schizophrenia, DID remains underdiagnosed and often misdiagnosed 4
- Studies indicate that patients with DID often have multiple psychiatric consultations before receiving the correct diagnosis 4
Differential Diagnosis
When considering DID, it's important to differentiate it from:
- Other dissociative disorders (dissociative amnesia, depersonalization/derealization disorder)
- Psychotic disorders (particularly when identity disturbance might be misinterpreted as delusions)
- Personality disorders
- Post-traumatic stress disorder with dissociative symptoms
- Substance-induced conditions 5
Assessment Challenges
- Diagnostic overshadowing can occur, where DID symptoms are attributed to other conditions 6
- Information should be gathered from multiple sources when possible, as self-reporting may be complicated by amnesia between identity states 6
- Structured interviews adapted for dissociative disorders can improve diagnostic accuracy
Common Pitfalls in Diagnosis
- Misattributing symptoms to more commonly diagnosed conditions like depression, anxiety, or psychotic disorders
- Failing to assess for dissociative symptoms during routine psychiatric evaluations
- Not recognizing that patients with DID often present with comorbid conditions (67.14% have comorbid depressive symptoms) 4
- Overlooking trauma history, which is frequently present in DID cases 4
Despite some historical controversy surrounding the diagnosis 3, DID remains a recognized condition in current diagnostic systems, with ongoing research focusing on improving treatment approaches and understanding its neurobiological underpinnings 7.