ICD-11 Criteria for Dissociative Disorders (6B60 )
Dissociative disorders are
characterised by involuntary disruption or discontinuity in the normal
integration of one or more of the following: identity, sensations, perceptions,
affects, thoughts, memories, control over bodily movements, or behaviour.
Disruption or discontinuity may be complete, but is more commonly partial, and
can vary from day to day or even from hour to hour. The symptoms of
dissociative disorders are not due the direct effects of a medication or
substance, including withdrawal effects, are not better explained by another
Mental, behavioural, or neurodevelopmental disorder, a Sleep-wake disorder, a
Disease of the nervous system or other health condition, and are not part of an
accepted cultural, religious, or spiritual practice. Dissociative symptoms in
dissociative disorders are sufficiently severe to result in significant
impairment in personal, family, social, educational, occupational or other
important areas of functioning.
Coded Elsewhere: Secondary
dissociative syndrome (6E65)
6B60 Dissociative neurological symptom disorder
Dissociative neurological symptom
disorder is characterised by the presentation of motor, sensory, or cognitive
symptoms that imply an involuntary discontinuity in the normal integration of
motor, sensory, or cognitive functions and are not consistent with a recognised
disease of the nervous system, other mental or behavioural disorder, or other
medical condition. The symptoms do not occur exclusively during another
dissociative disorder and are not due to the effects of a substance or
medication on the central nervous system, including withdrawal effects, or a
Sleep-Wake disorder.
Exclusions:
- Factitious disorders (BlockL1‑6D5)
6B60.0 Dissociative neurological symptom disorder, with visual disturbance
Dissociative neurological symptom disorder, with visual disturbance is characterised by visual symptoms such as blindness, tunnel vision, diplopia, visual distortions or hallucinations that are not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and do not occur exclusively during another dissociative disorder.
6B60.1 Dissociative neurological symptom disorder, with auditory disturbance
Dissociative neurological symptom disorder, with auditory disturbance is characterised by auditory symptoms such as loss of hearing or auditory hallucinations that are not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and do not occur exclusively during another dissociative disorder.
6B60.2 Dissociative neurological symptom disorder, with vertigo or dizziness
Dissociative neurological symptom disorder, with vertigo or dizziness is characterised by a sensation of spinning while stationary (vertigo) or dizziness that is not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and does not occur exclusively during another dissociative disorder.
6B60.3 Dissociative neurological symptom disorder, with other sensory disturbance
Dissociative neurological symptom disorder, with other sensory disturbance is characterised by sensory symptoms not identified in other specific categories in this grouping such as numbness, tightness, tingling, burning, pain, or other symptoms related to touch, smell, taste, balance, proprioception, kinesthesia, or thermoception. The symptoms are not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and do not occur exclusively during another dissociative disorder.
6B60.4 Dissociative neurological symptom disorder, with non-epileptic seizures
Dissociative neurological symptom disorder, with non-epileptic seizures is characterised by a symptomatic presentation of seizures or convulsions that are not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and do not occur exclusively during another dissociative disorder.
6B60.5 Dissociative neurological symptom disorder, with speech disturbance
Dissociative neurological symptom disorder, with speech disturbance is characterised by symptoms such as difficulty with speaking (dysphonia), loss of the ability to speak (aphonia) or difficult or unclear articulation of speech (dysarthria) that are not consistent with a recognised disease of the nervous system, a neurodevelopmental or neurocognitive disorder, other mental, behavioural or neurodevelopmental disorder, or other medical condition and do not occur exclusively during another dissociative disorder.
6B60.6 Dissociative neurological symptom disorder, with paresis or weakness
Dissociative neurological symptom disorder, with paresis or weakness is characterised by a difficulty or inability to intentionally move parts of the body or to coordinate movements that is not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and does not occur exclusively during another dissociative disorder.
6B60.7 Dissociative neurological symptom disorder, with gait disturbance
Dissociative neurological symptom disorder, with gait disturbance is characterised by symptoms involving the individual’s ability or manner of walking, including ataxia and the inability to stand unaided, that are not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and do not occur exclusively during another dissociative disorder.
6B60.8 Dissociative neurological symptom disorder, with movement disturbance
Dissociative neurological symptom disorder, with movement disturbance is characterised by symptoms such as chorea, myoclonus, tremor, dystonia, facial spasm, parkinsonism, or dyskinesia that are not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and do not occur exclusively during another dissociative disorder.
6B60.80 Dissociative neurological symptom disorder, with chorea
Dissociative neurological symptom disorder, with chorea is characterised by irregular, non-repetitive, brief, jerky, flowing movements that move randomly from one part of the body to another that are not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and do not occur exclusively during another dissociative disorder.
6B60.81 Dissociative neurological symptom disorder, with myoclonus
Dissociative neurological symptom disorder, with myoclonus is characterised by sudden rapid jerks that may be focal, multifocal or generalised that are not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and do not occur exclusively during another dissociative disorder.
6B60.82 Dissociative neurological symptom disorder, with tremor
Dissociative neurological symptom disorder, with tremor is characterised by involuntary oscillation of a body part that is not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and does not occur exclusively during another dissociative disorder.
6B60.83 Dissociative neurological symptom disorder, with dystonia
Dissociative neurological symptom disorder, with dystonia is characterised by sustained muscle contractions that frequently causing twisting and repetitive movements or abnormal postures that are not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and do not occur exclusively during another dissociative disorder.
6B60.84 Dissociative neurological symptom disorder, with facial spasm
Dissociative neurological symptom disorder, with facial spasm is characterised by involuntary muscle contractions or twitching of the face that is not consistent with a recognised disease of the nervous system, other mental, behavioural or neurodevelopmental disorder, or other medical condition and does not occur exclusively during another dissociative disorder.
6B60.85 Dissociative neurological symptom disorder, with Parkinsonism
Dissociative neurological symptom disorder, with Parkinsonism is characterised by a symptomatic presentation of a Parkinson-like syndrome in the absence of confirmed Parkinson disease that does not occur exclusively during another mental, behavioural or neurodevelopmental disorder, other medical condition, or another dissociative disorder. Dissociative neurological symptom disorder, with Parkinsonism can be distinguished from Parkinson disease by features such as abrupt onset, early disability, bilateral shaking and slowness, nondecremental slowness when performing repetitive movements, voluntary resistance against passive movement without cogwheel rigidity, distractability, ‘give-way’ weakness, stuttering speech, bizarre gait, and a variety of behavioural symptoms.
6B60.8Y Dissociative neurological symptom disorder, with other specified movement disturbance
6B60.8Z Dissociative neurological symptom disorder, with unspecified movement disturbance
6B60.9 Dissociative neurological symptom disorder, with cognitive symptoms
Dissociative neurological symptom
disorder, with cognitive symptoms is characterised by impaired cognitive
performance in memory, language or other cognitive domains that is internally
inconsistent and not consistent with a recognised disease of the nervous
system, a neurodevelopmental or neurocognitive disorder, other mental,
behavioural or neurodevelopmental disorder, or another medical condition and
does not occur exclusively during another dissociative disorder.
Exclusions:
- Dissociative amnesia (6B61)
6B60.Y Dissociative neurological symptom disorder, with other specified symptoms
6B60.Z Dissociative neurological symptom disorder, with unspecified symptoms
REFERENCE:
International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.
https://creativecommons.org/licenses/by-nc-nd/3.0/igo/
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