Category · F40-F48 block

F44 — Dissociative [conversion] disorders

Terminology note: Dissociative (or conversion) disorders involve a genuine, involuntary loss or alteration of a normally integrated function — memory, identity, sensation, or movement — that is not intentionally produced by the person and is not explained by a general medical or neurological condition. 'Conversion' is the older term for the same concept when physical (motor or sensory) functions are affected.

What is this category?

F44 covers presentations in which a specific psychological function normally under voluntary control (memory, identity, movement, or sensation) is lost or altered, typically in close temporal relationship to a stressful event, without an adequate organic explanation. Subtypes are organised by which function is affected: memory (dissociative amnesia), identity and travel (dissociative fugue), responsiveness (dissociative stupor), possession-like states (trance and possession disorders), and motor or sensory function (dissociative motor disorders, convulsions, and anaesthesia/sensory loss).

Core diagnostic concept

The defining feature of F44 is a genuine, involuntary disruption of a normally integrated function, in the absence of an adequate organic cause, and — critically — not intentionally or consciously produced by the person. This last point is what separates a genuine dissociative disorder from malingering (conscious feigning for an external incentive) or factitious disorder, and is often the single most important, and most frequently misunderstood, teaching point in this category.

Key diagnostic features

Loss or alteration of a normally integrated function: Memory, identity, movement, or sensation is disrupted in a way that is not consistent with how these functions are known to fail from organic disease.
Close temporal relationship to a stressful event: Onset often follows an identifiable stressful or traumatic event, though this is not universal.
No adequate organic explanation: A genuine medical or neurological cause has been actively looked for and not found, or the pattern of loss is inconsistent with how organic disease actually presents.
Not intentionally produced: The symptoms are not consciously or deliberately produced or feigned by the person, distinguishing this from malingering or factitious disorder.

How to weigh evidence

These learning labels are teaching aids, not official ICD-10 terminology (see Sources and Method).

supports A sudden loss of a specific function (memory, movement, or sensation) following a stressful event, with a pattern inconsistent with known organic disease and no adequate medical explanation found.
consistent not decisive A recent stressful event is present in the history, without yet enough detail on the pattern of symptom loss or the medical work-up completed.
raises alternative A pattern of loss that is fully consistent with a specific neurological lesion, or positive findings on medical investigation explaining the presentation.
contradicts or weakens Clear evidence that the symptom is being deliberately produced for a specific external incentive (such as a compensation claim), which would point toward malingering rather than a genuine dissociative disorder.
missing and necessary to ask Whether an adequate medical and neurological work-up has actually been completed and found no organic explanation.

Diagnostic boundary

F44 requires a genuine, involuntary loss or alteration of memory, identity, movement, or sensation, without an adequate organic explanation and without evidence of intentional production — never assumed to be feigned without specific evidence of deliberate, incentive-driven production.

Full comparisons:

Duration and course

Minimum duration: Variable; can be acute and transient or more prolonged, depending on the subtype.

Course: Often resolves once the underlying stressor is addressed or with time, though some presentations are more persistent.

Why this matters The pattern of onset (often following a stressor) and the specific function affected are usually more decisive for a vignette than duration alone.

Included presentations

Dissociative amnesia: sudden inability to recall important personal information, too extensive to be explained by ordinary forgetfulness.
Dissociative fugue: amnesia plus apparently purposeful travel away from home, with maintenance of basic self-care.
Dissociative stupor: profound reduction in voluntary movement and responsiveness without a physical cause.
Trance and possession disorders: temporary loss of the sense of personal identity, occurring involuntarily and outside culturally accepted contexts.
Dissociative motor disorders: loss of the ability to move all or part of a limb, without organic cause.
Dissociative convulsions: movements resembling an epileptic seizure but without the characteristic physiological changes of epilepsy.
Dissociative anaesthesia and sensory loss: loss of sensation in a pattern not consistent with known neurological pathways.

Exclusions and distinguishing presentations

Exclusions and where they point instead
If this is true instead…	Consider	Why
A pattern of loss fully consistent with a specific neurological lesion, or positive medical findings explaining the presentation	organic substance neurotic cause capsule	An adequate organic or neurological explanation should be actively excluded before a dissociative disorder is diagnosed.
Evidence of deliberate, incentive-driven production of the symptom	conversion symptoms are feigned	Genuine dissociative symptoms are not intentionally produced; specific evidence of deliberate feigning for an external incentive would point toward malingering instead, which is outside this block.
Dissociative symptoms occurring as one feature within a broader post-traumatic stress symptom cluster, rather than as the predominant presentation	F43	When re-experiencing, avoidance, and hyperarousal are the predominant, defining features, PTSD is the more accurate primary classification.

Four-character subtypes (orientation)

A learner should never assume a dissociative or conversion symptom is deliberately feigned without specific evidence of intentional, incentive-driven production — genuine, involuntary symptoms are the defining feature of this category, and an organic cause should always be actively excluded first.

F44.0 — Dissociative amnesia: Sudden loss of memory for important personal information, too extensive for ordinary forgetfulness. (in_depth)
F44.1 — Dissociative fugue: Amnesia plus apparently purposeful travel away from home. (taught for orientation only, not separately assessed in this pilot)
F44.2 — Dissociative stupor: Profound reduction in movement and responsiveness without physical cause. (taught for orientation only, not separately assessed in this pilot)
F44.3 — Trance and possession disorders: Temporary loss of personal identity, involuntary and outside culturally accepted contexts. (taught for orientation only, not separately assessed in this pilot)
F44.4 — Dissociative motor disorders: Loss of the ability to move all or part of a limb, without organic cause. (in_depth)
F44.5 — Dissociative convulsions: Movements resembling a seizure but without epilepsy's physiological changes. (taught for orientation only, not separately assessed in this pilot)
F44.6 — Dissociative anaesthesia and sensory loss: Sensory loss in a pattern inconsistent with known neurological pathways. (in_depth)
F44.7 — Mixed dissociative [conversion] disorders: A combination of the above presentations. (taught for orientation only, not separately assessed in this pilot)
F44.8 — Other dissociative [conversion] disorders: A dissociative presentation not matching the named subtypes. (taught for orientation only, not separately assessed in this pilot)
F44.9 — Dissociative [conversion] disorder, unspecified: A dissociative disorder identified but without enough information to specify further. (taught for orientation only, not separately assessed in this pilot)

External causes to check first

Categories in this block require that the disturbance is not better explained by another external cause listed below. These short capsules are reminders, not full teaching modules.

External cause capsule — Organic, medical, or substance-related presentations resembling F40-F48

A reminder that a presentation resembling an anxiety, obsessive-compulsive, stress-related, dissociative, or somatoform disorder can instead be caused by a general medical condition (e.g. hyperthyroidism producing anxiety-like symptoms, a neurological condition producing genuine sensory or motor loss) or a substance/medication (e.g. caffeine or stimulant intoxication, sedative or alcohol withdrawal producing anxiety symptoms) rather than being a primary F40-F48 disorder, and that this should be actively considered before a primary F40-F48 classification is settled.

What to check:

Timing: did the symptoms begin during or shortly after starting, stopping, intoxication with, or withdrawal from a substance or medication known to produce anxiety, dissociative, or somatic symptoms?
Medical context: is there a known medical or neurological condition (e.g. thyroid disease, a cardiac arrhythmia, a neurological lesion) with a recognised association with the symptoms described?
Adequacy of investigation: has an appropriate medical or neurological work-up actually been completed, rather than simply not yet undertaken?
Course after the cause is addressed: symptoms that substantially improve once the medical condition is treated or the substance/medication is stopped weigh toward a secondary cause rather than a primary F40-F48 disorder.

A full teaching module on F00-F09 (organic mental disorders) or F10-F19 (substance-related disorders), or a general medical work-up, all of which are outside this capsule's scope.

External cause capsule — Genuineness of dissociative and somatoform symptoms

A reminder that dissociative [conversion] and somatoform symptoms are not intentionally or consciously produced by the person experiencing them, which is what separates a genuine F44 or F45 presentation from malingering (conscious feigning for an external incentive, such as a compensation claim or avoiding an obligation) or factitious disorder (conscious feigning for an internal psychological need), both of which fall outside this block's scope.

What to check:

Evidence of a specific, identifiable external incentive (financial, legal, or avoidance of a specific obligation) actually driving the presentation, rather than an incentive merely being hypothetically possible.
Whether the symptom pattern is consistent with what is known about genuine dissociative or somatoform presentations, or instead closely tracks what would maximise the suspected external benefit.
Absence of an identifiable incentive, and a symptom pattern consistent with genuine dissociative or somatoform presentations, both weigh toward a genuine disorder rather than feigning.
The default assumption, absent specific evidence to the contrary, should be that the person's distress and symptoms are genuine.

A full clinical assessment of secondary gain or a forensic evaluation, both of which require specialised judgement and evidence well beyond what a single vignette can establish.

Worked example — distinguishing genuine dissociative amnesia from ordinary forgetfulness

A 30-year-old is found by police unable to recall her name, home address, or any autobiographical detail from the past several years, though she can still speak fluently, navigate her surroundings, and recall general knowledge. This began abruptly the day after she witnessed a violent assault. A full neurological work-up, including brain imaging, is normal, and there is no history of head injury or substance use. She has no known reason to feign memory loss, such as a pending legal or financial matter.

Step 1 — Note the pattern: loss of autobiographical memory (name, address, recent years) with preserved general knowledge and procedural ability (speech, navigation) — inconsistent with typical organic amnesia, which usually spares recent autobiographical memory less selectively.
Step 2 — Note the temporal link: abrupt onset the day after witnessing a violent assault.
Step 3 — Check for organic cause: normal neurological work-up and imaging, no head injury or substance use — no adequate organic explanation found.
Step 4 — Check for evidence of intentional production: no known incentive to feign memory loss is described.
Conclusion — F44.0, Dissociative amnesia — a genuine, involuntary, stressor-linked memory disturbance with no organic cause and no evidence of deliberate feigning.

Interactive practice

Type A Found without a name Recognition / application · Foundation
Type B Sudden weakness, no incentive in sight Boundary discrimination · Transfer

Retrieval prompts

Try answering each of these from memory before revealing where to check. Nothing you think or type here is sent or saved anywhere.

State the four key features that together define a dissociative [conversion] disorder.

Reveal answer location

Check Duration and course, Diagnostic boundary, or the rapid revision card below — the cue you need is one of those, in this category's own already-authored wording.
Explain why a genuine dissociative symptom should not be assumed to be feigned without specific evidence.

Reveal answer location

Check Duration and course, Diagnostic boundary, or the rapid revision card below — the cue you need is one of those, in this category's own already-authored wording.
Name the functional domains F44's subtypes are organised around.

Reveal answer location

Check Duration and course, Diagnostic boundary, or the rapid revision card below — the cue you need is one of those, in this category's own already-authored wording.

These self-checks are a personal study aid only, visible to you on this page for this visit — they are not stored and do not affect your mastery dimensions.

Rapid revision card

F44: F44 requires a genuine, involuntary loss or alteration of memory, identity, movement, or sensation, without organic cause and without evidence of intentional production.

Decisive boundary cues:

Sudden, stressor-linked loss of function, inconsistent with organic disease, no adequate medical explanation -> weighs toward F44.
A pattern fully consistent with a specific neurological lesion, or positive medical findings -> weighs toward an organic cause instead.
Specific evidence of deliberate, incentive-driven production -> weighs toward malingering, outside this block, not F44.

Duration/course: Variable — often resolves once the stressor is addressed or with time; some presentations are more persistent.

Nearest alternatives: f43, f45

Common mistake: Assuming a dissociative or conversion symptom is consciously feigned without specific evidence of deliberate, incentive-driven production.

Retrieval prompt: Has an adequate organic cause genuinely been excluded, and is there any actual evidence this symptom is being intentionally produced?

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Related glossary terms

Dissociation

A disruption in the normally integrated functioning of memory, identity, perception, or consciousness, such that one or more of these functions becomes separated from the others, often in close relationship to a stressful event and without an adequate organic explanation. When this disruption becomes clinically significant and persistent, it is classified under F44.

Open full glossary entry →
Conversion (symptom)

The older term for a dissociative symptom specifically affecting motor or sensory function — for example, a sudden loss of movement in a limb or a loss of sensation — occurring without an adequate organic explanation and not intentionally produced. Classified under F44 (e.g. F44.4, F44.6).

Open full glossary entry →

Source basis

WHO ICD-10 international classification structure and code/title (ICD-10 Browser, 2019 English release).

Original educational synthesis, informed by general published clinical-education understanding of ICD-10 F40-F48; no verbatim CDDG or DCR text is reproduced. See Sources and Method for the full policy.

Last reviewed: 2026-09-16. Full policy: Sources and Method.

Educational resource only. This page and its cases teach ICD-10 classification reasoning using fictional scenarios. It does not diagnose real people and should not be used to assess yourself or anyone else. If you or someone you know is struggling with anxiety, intrusive thoughts, the effects of a stressful or traumatic event, or persistent physical symptoms, please seek prompt professional evaluation.

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