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Maladaptive daydreaming should be included as a dissociative disorder in psychiatric manuals : Position paper

Soffer-Dudek, Nirit ; Somer, Eli ; Spiegel, David ; Chefetz, Richard ; O'Neil, John ; Dorahy, Martin and Cardeña, Etzel LU orcid (2025) In British Journal of Psychiatry 226(4). p.238-242
Abstract
Maladaptive daydreaming is a distinct syndrome in which the
main symptom is excessive vivid fantasising that causes
clinically significant distress and functional impairment in
academic, vocational and social domains. Unlike normal
daydreaming, maladaptive daydreaming is persistent, compulsive
and detrimental to one’s life. It involves detachment
from reality in favour of intense emotional engagement with
alternative realities and often includes specific features such as
psychomotor stereotypies (e.g. pacing in circles, jumping or
shaking one’s hands), mouthing dialogues, facial gestures or
enacting fantasy events. Comorbidity is common, but existing
disorders do not account for the phenomenology... (More)
Maladaptive daydreaming is a distinct syndrome in which the
main symptom is excessive vivid fantasising that causes
clinically significant distress and functional impairment in
academic, vocational and social domains. Unlike normal
daydreaming, maladaptive daydreaming is persistent, compulsive
and detrimental to one’s life. It involves detachment
from reality in favour of intense emotional engagement with
alternative realities and often includes specific features such as
psychomotor stereotypies (e.g. pacing in circles, jumping or
shaking one’s hands), mouthing dialogues, facial gestures or
enacting fantasy events. Comorbidity is common, but existing
disorders do not account for the phenomenology of the
symptoms. Whereas non-specific therapy is ineffective,
targeted treatment seems promising. Thus, we propose
that maladaptive daydreaming be considered a formal
syndrome in psychiatric taxonomies, positioned within the
dissociative disorders category. Maladaptive daydreaming
satisfactorily meets criteria for conceptualisation as a psychiatric
syndrome, including reliable discrimination from other
disorders and solid interrater agreement. It involves significant
dissociative aspects, such as disconnection from perception,
behaviour and sense of self, and has some commonalities with
but is not subsumed under existing dissociative disorders.
Formal recognition of maladaptive daydreaming as a
dissociative disorder will encourage awareness of a growing
problem and spur theoretical, research and clinical
developments. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
dissociative disorders
in
British Journal of Psychiatry
volume
226
issue
4
pages
238 - 242
publisher
Cambridge University Press
external identifiers
  • scopus:105000560315
  • pmid:40094484
ISSN
0007-1250
DOI
10.1192/bjp.2024.279
language
English
LU publication?
yes
id
bb6d46b5-8c76-4a3a-a73b-f401584d235e
date added to LUP
2025-06-03 10:04:29
date last changed
2025-06-06 03:00:02
@article{bb6d46b5-8c76-4a3a-a73b-f401584d235e,
  abstract     = {{Maladaptive daydreaming is a distinct syndrome in which the<br/>main symptom is excessive vivid fantasising that causes<br/>clinically significant distress and functional impairment in<br/>academic, vocational and social domains. Unlike normal<br/>daydreaming, maladaptive daydreaming is persistent, compulsive<br/>and detrimental to one’s life. It involves detachment<br/>from reality in favour of intense emotional engagement with<br/>alternative realities and often includes specific features such as<br/>psychomotor stereotypies (e.g. pacing in circles, jumping or<br/>shaking one’s hands), mouthing dialogues, facial gestures or<br/>enacting fantasy events. Comorbidity is common, but existing<br/>disorders do not account for the phenomenology of the<br/>symptoms. Whereas non-specific therapy is ineffective,<br/>targeted treatment seems promising. Thus, we propose<br/>that maladaptive daydreaming be considered a formal<br/>syndrome in psychiatric taxonomies, positioned within the<br/>dissociative disorders category. Maladaptive daydreaming<br/>satisfactorily meets criteria for conceptualisation as a psychiatric<br/>syndrome, including reliable discrimination from other<br/>disorders and solid interrater agreement. It involves significant<br/>dissociative aspects, such as disconnection from perception,<br/>behaviour and sense of self, and has some commonalities with<br/>but is not subsumed under existing dissociative disorders.<br/>Formal recognition of maladaptive daydreaming as a<br/>dissociative disorder will encourage awareness of a growing<br/>problem and spur theoretical, research and clinical<br/>developments.}},
  author       = {{Soffer-Dudek, Nirit and Somer, Eli and Spiegel, David and Chefetz, Richard and O'Neil, John and Dorahy, Martin and Cardeña, Etzel}},
  issn         = {{0007-1250}},
  keywords     = {{dissociative disorders}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{238--242}},
  publisher    = {{Cambridge University Press}},
  series       = {{British Journal of Psychiatry}},
  title        = {{Maladaptive daydreaming should be included as a dissociative disorder in psychiatric manuals : Position paper}},
  url          = {{http://dx.doi.org/10.1192/bjp.2024.279}},
  doi          = {{10.1192/bjp.2024.279}},
  volume       = {{226}},
  year         = {{2025}},
}