Skip to content
Contents

Dissociative Disorders Protocols, Treatment, Staff Training

Reference: 25-26058

Date response sent: 20/05/2025

Details of enquiry

  1. Does your trust have any specific clinical care pathways, protocols, or service guidance specifically for the treatment or management of patients with:

a. Dissociative disorders (including DID, OSDD, DPDR etc..)?

b. Complex post-traumatic presentations involving dissociation?

2. If yes, please provide copies of any relevant documentation or pathway flowcharts.

3. Which clinical teams or services (e.g. CMHTs, trauma services, personality disorder services, psychology/psychotherapy teams) typically provide care for patients with dissociative disorders and dissociative presentations?

4. Does your trust offer or commission any specialist assessment or treatment (e.g. SCID-D diagnostic assessment) specifically for dissociative disorders?

5. Are patients with dissociative disorders referred to external providers (e.g. Centre for Dissociative Studies, Pottergate Centre, or other independent services)? If so, under what circumstances?

6. Has your trust delivered any training or guidance for clinicians on dissociative disorders in the past five years?

7. If possible, please provide the number or percentage of current patients under your care who have a diagnosis of a dissociative disorder. This may include conditions coded under ICD-10 (eg. F44.8), ICD-11 (e.g. 6B64) or equivalent SNOMED CT terms. (If your trust uses other diagnostic classification systems such as DSM, please indicate where applicable.)

Response sent

  1. Does your trust have any specific clinical care pathways, protocols, or service guidance specifically for the treatment or management of patients with:

a. Dissociative disorders (including DID, OSDD, DPDR etc…)?

We are not specifically commissioned to provide these services. Some of our patients present with dissociative features, it is not something which we accept  referrals for as part of a primary formulation / diagnosis but as part of a referral for a Complex Trauma condition. We have seen patients with DID in the trauma service and have extended our treatment from 18 months weekly to 4 years. However this is not commissioned or funded and as such no longer possible. We have set up a trauma forum in the wider ICB to try to audit and address the lack of a DID specific pathway in the area.

b. Complex post-traumatic presentations involving dissociation?

Please refer to our response at 1a) above.

  1. If yes, please provide copies of any relevant documentation or pathway flowcharts.

Not applicable, please refer to our response at 1a) above

  1. Which clinical teams or services (e.g. CMHTs, trauma services, personality disorder services, psychology/psychotherapy teams) typically provide care for patients with dissociative disorders and dissociative presentations?

Adults:     Trauma Team (adults only)

Adolescent and Young Adults (14-25 years of age)

  1. Does your trust offer or commission any specialist assessment or treatment (e.g. SCID-D diagnostic assessment) specifically for dissociative disorders?

Please refer to our above answers at question 1a) and question 3. We do use DES if we suspect dissociative disorders

  1. Are patients with dissociative disorders referred to external providers (e.g. Centre for Dissociative Studies, Pottergate Centre, or other independent services)? If so, under what circumstances?

No not usually, we would consider onward referral as and when needed but would not normally consider private providers.

  1. Has your trust delivered any training or guidance for clinicians on dissociative disorders in the past five years?

The Trust has an internal workshop in the trauma service for DID. We have also held lectures as a part of the external trauma lecture series on DID. We also have lectures on dissociation and DID (Dissociative Identity Disorder) in our 2 year trauma course

  1. If possible, please provide the number or percentage of current patients under your care who have a diagnosis of a dissociative disorder. This may include conditions coded under ICD-10 (eg. F44.8), ICD-11 (e.g. 6B64) or equivalent SNOMED CT terms. (If your trust uses other diagnostic classification systems such as DSM, please indicate where applicable.)

We do not hold our data in a way that enables us to provide the number or percentage of current patients under our care who have presented with secondary condition and/or diagnosis of a dissociative disorder, and this data might only be held as text within the notes section of a patient’s electronic record from which automated reports cannot be run to collate this data.

ICD-10 and other diagnosis/discharge codes such as , ICD11, SNOMED DSM do not form part of the Trust’s specialist psychoanalytic and psychodynamic based approach to working with adults They do not constitute mandatory data fields for patient discharge records, so their application is sporadic as we do not tend to record these very often.

Of the trauma services’ current active caseload,  less than 0.5% have a diagnosis of DID.  We recognize that there may be more that have not yet been diagnosed.

 

 

Back to top