title: Dissociative disorders in DSM-5.
abstract: BACKGROUND
  We present recommendations for revision of the diagnostic criteria for the Dissociative Disorders (DDs) for DSM-5. The periodic revision of the DSM provides an opportunity to revisit the assumptions underlying specific diagnoses and the empirical support, or lack of it, for the defining diagnostic criteria.
  
  
  METHODS
  This paper reviews clinical, phenomenological, epidemiological, cultural, and neurobiological data related to the DDs in order to generate an up-to-date, evidence-based set of DD diagnoses and diagnostic criteria for DSM-5. First, we review the definitions of dissociation and the differences between the definitions of dissociation and conceptualization of DDs in the DSM-IV-TR and the ICD-10, respectively. Also, we review more general conceptual issues in defining dissociation and dissociative disorders. Based on this review, we propose a revised definition of dissociation for DSM-5 and discuss the implications of this definition for understanding dissociative symptoms and disorders.
  
  
  RESULTS
  We make the following recommendations for DSM-5: 1. Depersonalization Disorder (DPD) should include derealization symptoms as well. 2. Dissociative Fugue should become a subtype of Dissociative Amnesia (DA). 3. The diagnostic criteria for DID should be changed to emphasize the disruptive nature of the dissociation and amnesia for everyday as well as traumatic events. The experience of possession should be included in the definition of identity disruption. 4. Dissociative Trance Disorder should be included in the Unspecified Dissociative Disorder (UDD) category.
  
  
  CONCLUSIONS
  There is a growing body of evidence linking the dissociative disorders to a trauma history, and to specific neural mechanisms.
authors.affiliation: Department of Psychiatry, Stanford University, Palo Alto, California, USA. dspiegel@stanford.edu
authors.forename: David
authors.initials: D
authors.lastname: Spiegel
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Loewenstein
authors.forename: Roberto
authors.initials: R
authors.lastname: Lewis-Fernández
authors.forename: Vedat
authors.initials: V
authors.lastname: Sar
authors.forename: Daphne
authors.initials: D
authors.lastname: Simeon
authors.forename: Eric
authors.initials: E
authors.lastname: Vermetten
authors.forename: Etzel
authors.initials: E
authors.lastname: Cardeña
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Brown
authors.forename: Paul F
authors.initials: PF
authors.lastname: Dell
mesh_terms: D039721:Diagnostic and Statistical Manual of Mental Disorders; D004213:Dissociative Disorders / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans