Dissociative disorders

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Target exams

Red flags

• Active suicidal intent, plan, or escalating self-injury with dissociation — same-day senior review, means restriction, documented safety plan
• First-onset identity alteration or amnesia with focal neurology, seizure clues, fever, or marked confusion — medical/organic work-up before psychiatric labelling
• Fugue with wandering, inability to care for self, or inability to give history — urgent safety and capacity assessment
• Aggressive 'memory recovery', hypnosis, or leading interviews that risk confabulation and iatrogenic harm
• Presuming schizophrenia from internal voices alone without assessing reality testing, thought form, and amnesia pattern
• Returning a patient to ongoing interpersonal violence or coercive control while starting trauma processing