Trance and Possession Disorder (ICD-11: 6B63): Complete Guide for Clinical Coding

1. Introduction

Trance and Possession Disorder represents a complex dissociative condition that challenges mental health professionals in various clinical contexts around the world. Characterized by altered states of consciousness where personal identity is replaced by an external entity perceived as a "possessor," this disorder requires careful differentiation from normative cultural and religious practices, as well as from other psychiatric and neurological conditions.

The clinical importance of this diagnosis lies in the need to distinguish pathological manifestations that cause significant distress and functional impairment from culturally sanctioned experiences of trance or possession that occur in specific ritual contexts. This distinction is fundamental to avoid pathologization of legitimate cultural practices, while simultaneously ensuring appropriate treatment for individuals genuinely affected by involuntary and distressing dissociative symptoms.

The prevalence of Trance and Possession Disorder varies considerably among different regions and cultures, being more frequently identified in societies where beliefs about spiritual possession are culturally prevalent. However, cases also occur in contexts where such beliefs are less common, often manifesting through other explanatory narratives.

Precise coding with code 6B63 is critical for adequate clinical documentation, appropriate therapeutic planning, resource allocation in health systems, epidemiological research, and ensuring that patients receive evidence-based interventions specific to dissociative disorders.

2. Correct ICD-11 Code

Code: 6B63

Description: Trance and possession disorder

Parent category: Dissociative disorders

Complete official definition: Possession trance disorder is characterized by trance states in which there is a marked alteration in the individual's state of consciousness and the individual's customary sense of personal identity is replaced by an external "possessing" identity, in which the individual's behaviors or movements are experienced as being controlled by the possessing agent.

Episodes must be recurrent or, if the diagnosis is based on a single episode, it must last for at least several days. Critically, the possession trance state must be involuntary and unwanted, not being accepted as part of a collective cultural or religious practice.

The definition establishes multiple exclusions: symptoms cannot occur exclusively during another dissociative disorder nor be better explained by another mental, behavioral, or neurodevelopmental disorder. Additionally, effects of substances, medications, withdrawal, exhaustion, hypnagogic or hypnopompic states, nervous system diseases, head trauma, or sleep-wake disorders must be excluded.

Finally, symptoms must result in significant distress or substantial impairment in the individual's personal, family, social, educational, occupational, or other important areas of functioning.

3. When to Use This Code

Scenario 1: Recurrent Episodes of Involuntary Alternate Identity

A 28-year-old female patient presents with recurrent episodes where she claims to be controlled by an entity she identifies as an ancient male spirit. During these episodes, which occur several times per week and last 2 to 6 hours, her voice changes in tone, she assumes different body postures, and reports having no control over her actions. These episodes do not occur during religious practices, cause significant distress to the patient, and have resulted in job loss due to unpredictable behaviors. Neurological evaluation ruled out epilepsy or other organic conditions.

Criteria present: marked alteration of consciousness, substitution of personal identity, recurrent episodes, involuntariness, significant suffering, functional impairment, exclusion of organic causes.

Scenario 2: Single Prolonged Episode with Functional Deterioration

A 35-year-old male developed a persistent state lasting 12 days where he believes he is possessed by multiple entities that control different parts of his body. He is unable to work, care for himself, or recognize family members during these states. This is his first episode, but its prolonged duration and severity justify the diagnosis. The patient has never participated in religious practices involving possession and is extremely distressed by the experience.

Criteria present: single episode lasting several days, severe alteration of consciousness, severe functional impairment, involuntariness, absence of sanctioned cultural/religious context.

Scenario 3: Differentiation from Cultural Practice

A 42-year-old female regularly participated in religious ceremonies where possession states are expected and valued. However, six months ago she began experiencing possession episodes outside the ritual context, in everyday situations such as at work or at home. These non-ritual episodes are involuntary, cause significant embarrassment, and interfere with her professional life. Evaluation confirms that the problematic episodes are qualitatively different from controlled ritual experiences.

Criteria present: clear distinction between normative cultural experiences and involuntary pathological episodes, suffering and impairment specifically related to culturally non-sanctioned episodes.

Scenario 4: Post-Traumatic Presentation

A 30-year-old male, following a significant traumatic experience, develops recurrent episodes where he feels a "dark presence" assumes control of his body. During these episodes, he displays uncharacteristic aggressive behaviors, has incomplete memory of what occurred, and experiences alterations in self-perception. The episodes occur 2-3 times per week, last several hours, and have resulted in social isolation and inability to maintain relationships.

Criteria present: recurrent episodes, alteration of consciousness and identity, functional impairment, exclusion of other primary dissociative disorders.

Scenario 5: Manifestation with Occupational Impairment

A 45-year-old healthcare professional experiences episodes where she believes she is possessed by an entity that "speaks through her." These episodes began eight months ago, occur without warning, last 1 to 4 hours, and have resulted in multiple incidents at work. The patient is distressed, has never had similar experiences in religious contexts, and comprehensive medical evaluation identified no organic causes, substance use, or other primary mental disorders.

Criteria present: recurrence, involuntariness, significant occupational impairment, marked suffering, exclusion of other etiologies.

4. When NOT to Use This Code

Exclusion: Schizophrenia (related code: 1683919430)

Do not use 6B63 when symptoms of "possession" are part of a broader delusional system with other persistent psychotic symptoms such as continuous auditory hallucinations, disorganization of thought, or negative symptoms. In schizophrenia, the belief of being possessed is typically a delusion within a more comprehensive psychotic presentation, without the characteristic dissociative trance states.

Exclusion: Disorders due to use of psychoactive substances (related code: 136511187)

When states of altered consciousness and strange behaviors occur exclusively during intoxication or withdrawal from substances, the appropriate code relates to substance use disorder. Detailed history of substance use and the temporal relationship between use and symptoms are fundamental for this differentiation.

Exclusion: Acute and transient psychotic disorder (related code: 284410555)

Acute psychotic states that arise abruptly, with limited duration (usually days to weeks) and complete recovery, even if they include themes of possession, are more appropriately coded as acute psychotic disorder. The presence of florid psychotic symptoms beyond the experience of possession and the acute and self-limited temporal pattern are distinctive.

Exclusion: Secondary personality change (related code: 1324394161)

When persistent changes in personality occur secondary to identifiable medical conditions (head trauma, brain tumors, encephalitis), the appropriate code reflects secondary personality change. The presence of clear organic etiology and persistent (not episodic) personality changes are distinctive characteristics.

Differentiation from Normative Cultural Practices

Fundamental to the correct use of code 6B63 is not applying it to experiences of trance or possession that occur within sanctioned cultural or religious contexts, are voluntary or desired, do not cause significant distress, and do not result in functional impairment. Participation in religious ceremonies, traditional healing rituals, or spiritual practices where trance states are expected and valued does not constitute a mental disorder.

5. Step-by-Step Coding Process

Step 1: Assess Diagnostic Criteria

Confirmation of dissociative trance state:

• Document observable alterations in state of consciousness during episodes
• Assess the presence of partial or complete amnesia for events
• Identify changes in responsiveness to external stimuli
• Record alterations in perception of self and environment

Confirmation of identity substitution:

• Interview the patient about the subjective experience of being controlled by an external entity
• Document behavioral, language, or posture changes during episodes
• Assess whether the patient attributes actions and thoughts to a distinct "possessing agent"
• Verify whether there is a consistent narrative about the "possessing" identity

Recommended assessment instruments:

• Dissociative Experiences Scale (DES) for screening dissociative symptoms
• Structured Clinical Interview for Dissociative Disorders (SCID-D)
• Dissociative Experiences Questionnaire (DES-II)
• Detailed functional assessment using global functioning scales

Step 2: Verify Specifiers

Duration and frequency:

• Recurrent episodes: document frequency, typical duration of each episode, and temporal pattern
• Single episode: confirm minimum duration of several consecutive days
• Record variability in presentation between episodes

Severity:

• Mild: minimal functional impairment, able to maintain essential activities with difficulty
• Moderate: significant functional impairment in multiple areas, difficulty maintaining routines
• Severe: severe functional impairment, inability for self-care or independent functioning

Context and triggers:

• Identify possible stressors or precipitating situations
• Document whether there is a pattern related to previous traumatic events
• Assess presence of comorbidities such as post-traumatic stress disorder

Step 3: Differentiate from Other Codes

6B60 - Dissociative neurological symptom disorder: Key difference: In 6B60, symptoms involve alterations in motor or sensory function (paralyses, non-epileptic seizures, blindness) without the experience of identity substitution by an external entity. In 6B63, the central aspect is the experience of possession and control by an external agent, not simply functional neurological symptoms.

6B61 - Dissociative amnesia: Key difference: Dissociative amnesia involves inability to recall important personal information, usually of a traumatic nature, without trance states or experience of possession. In 6B63, although there may be amnesia for the possession episodes, the defining element is the trance state with identity substitution, not isolated amnesia.

6B62 - Trance disorder: Key difference: This is the most subtle distinction. 6B62 involves trance states with altered consciousness, but WITHOUT the experience of possession or identity substitution by an external entity. In 6B63, the possession component—the experience of being controlled by an identifiable external agent—is essential and clearly distinguishes the two disorders.

Step 4: Required Documentation

Checklist of mandatory information:

□ Detailed description of trance episodes (onset, duration, termination) □ Characteristics of the "possessing" identity as reported by the patient □ Frequency and temporal pattern of episodes □ Level of consciousness and memory during and after episodes □ Behaviors observed during possession states □ Specific functional impact (work, relationships, self-care) □ Level of patient's subjective distress □ Patient's cultural and religious context □ Exclusion of participation in sanctioned ritualistic practices □ Results of neurological and general medical evaluation □ Exclusion of substance use or medications □ Assessment of psychiatric comorbidities □ History of trauma or significant stressful events □ Previous treatment attempts and response

Appropriate documentation: Documentation should include both objective descriptions of observed behaviors and detailed subjective reports from the patient about their experiences. Record direct quotations when possible, especially regarding the experience of possession. Document assessments from multiple sources when available (family members, colleagues) to corroborate functional impact and the involuntary nature of episodes.

6. Complete Practical Example

Clinical Case

Initial presentation: Maria, 32 years old, a teacher, was referred to the mental health service by her family physician after multiple consultations for "strange episodes". During the initial evaluation, she reported that approximately eight months ago she began experiencing episodes where "she is no longer herself". These episodes occur 2-3 times per week, usually without warning, and last from 1 to 5 hours.

During the episodes, Maria reports that an "ancient presence" takes control of her body. She describes feeling "pushed back" while observing her own movements without being able to control them. The "presence" speaks through her with a different voice, uses archaic vocabulary, and makes statements about historical events. Maria has partial memory of these episodes, vaguely remembering what occurred as if watching from a distance.

Evaluation performed:

Detailed history: The episodes began three months after a car accident in which Maria suffered minor injuries but witnessed serious injuries in another driver. There is no history of participation in religious practices involving trance or possession. Maria was raised in a secular family and describes herself as non-religious. She denies use of alcohol, drugs, or psychoactive medications.

Mental status examination: Outside of episodes, Maria presents as oriented, with logical and organized thinking, without psychotic symptoms. She demonstrates insight that the episodes are problematic and expresses significant distress. There is no evidence of persistent psychotic symptoms, delusions, or hallucinations outside of possession episodes.

Complementary evaluations:

• Brain magnetic resonance imaging: unremarkable
• Electroencephalogram: normal, without epileptiform activity
• Laboratory tests: thyroid function, complete blood count, electrolytes normal
• Dissociative Experiences Scale (DES): score of 42 (significantly elevated)
• Neuropsychological evaluation: cognitive functions preserved

Functional impact: Maria had to request medical leave from work after an episode occurred during a class, frightening the students. She avoids social situations for fear of having episodes in public. Marital relationship significantly affected, with the spouse reporting confusion and concern. She developed anticipatory anxious symptoms related to fear of new episodes.

Diagnostic Reasoning

Inclusion criteria present:

1. Trance states with marked alteration of consciousness (confirmed by report and observation)
2. Replacement of personal identity by external "possessing" identity (ancient presence)
3. Experience of behaviors controlled by the possessing agent (confirmed)
4. Recurrent episodes (2-3 times per week for 8 months)
5. Involuntariness and unwanted nature (confirmed by significant distress)
6. Not part of collective cultural or religious practice (confirmed by history)
7. Significant suffering and functional impairment (work, social, marital)

Exclusions verified:

• Does not occur exclusively during another dissociative disorder
• Not better explained by schizophrenia (absence of persistent psychotic symptoms)
• Not due to substances or medications (negative history and tests)
• Not due to neurological condition (normal MRI and EEG)
• Not due to sleep-wake disorder (episodes occur during full wakefulness)

Differential diagnoses considered and ruled out:

Trance disorder (6B62): Ruled out because the central element is specifically the experience of possession by an external entity, not merely a trance state.

Psychotic disorder: Ruled out by the absence of persistent psychotic symptoms outside of episodes and by the episodic and dissociative nature of the presentation.

Temporal lobe epilepsy: Ruled out by normal EEG and clinical characteristics not consistent with complex partial seizures.

Coding Step by Step

Step 1: Confirmation that all diagnostic criteria for 6B63 are present as per the analysis above.

Step 2: Determination of severity as moderate to severe, based on significant occupational impairment (work leave) and impact on interpersonal relationships.

Step 3: Clear differentiation from other dissociative disorders, particularly 6B62, based on the specific presence of the possession component.

Step 4: Complete documentation including description of episodes, exclusion of organic causes, functional impact, and cultural context.

Code chosen: 6B63 - Trance and possession disorder

Complete justification: The code 6B63 is appropriate because Maria presents all essential elements: recurrent trance states with altered consciousness, specific experience of possession by an external entity that controls her behaviors, involuntary and unwanted nature of the episodes, absence of sanctioned cultural/religious context, and suffering with significant functional impairment. All exclusion conditions were appropriately ruled out through comprehensive medical and psychiatric evaluation.

Applicable complementary codes:

• Consider additional code for Post-Traumatic Stress Disorder if full criteria are present related to the car accident
• Code for Generalized Anxiety Disorder if secondary anxious symptoms meet diagnostic criteria

7. Related Codes and Differentiation

Within the Same Category

6B60: Dissociative neurological symptom disorder

When to use 6B60 vs. 6B63: Use 6B60 when the patient presents with symptoms suggesting a neurological condition (weakness, paralysis, abnormal movements, non-epileptic seizures, sensory alterations) without an identifiable organic basis, but WITHOUT the experience of possession or identity substitution.

Main difference: In 6B60, the focus is on dissociative functional neurological symptoms. In 6B63, the defining element is the subjective experience of being possessed or controlled by an external entity, with alteration of personal identity. A patient may have dissociative seizures (6B60) without ever experiencing possession, or may have possession experiences (6B63) without functional neurological symptoms.

6B61: Dissociative amnesia

When to use 6B61 vs. 6B63: Code 6B61 is appropriate when the predominant symptom is the inability to recall important personal information, usually of a traumatic or stressful nature, which cannot be explained by normal forgetting. The amnesia is not associated with trance states or possession experiences.

Main difference: In dissociative amnesia, the central problem is loss of autobiographical memory without identity alteration or possession states. In 6B63, although there may be amnesia for periods of possession, the defining symptom is the trance state with identity substitution, not amnesia itself. If a patient has only memory gaps without possession experiences, use 6B61.

6B62: Trance disorder

When to use 6B62 vs. 6B63: This is the most critical differentiation. Use 6B62 when the patient experiences involuntary and unwanted trance states with altered consciousness, but WITHOUT the experience of possession—that is, without feeling that an external entity has assumed control or substituted their identity.

Main difference: 6B62 involves altered consciousness and reduced responsiveness to the environment, but the individual maintains a sense of personal identity, even if altered. In 6B63, there is specifically the experience that an external "possessing" identity has substituted personal identity and controls behaviors. The presence or absence of the possession component is the dividing line between these two codes.

Differential Diagnoses from Other Categories

Dissociative Identity Disorder: Although not listed in the related codes provided, it is important to differentiate it from 6B63. In Dissociative Identity Disorder, there are two or more distinct personality states that alternate control, each with their own patterns of perception and relationship. In 6B63, the "possessing identity" is experienced as external and alien to the self, not as an alternative part of one's own personality.

Psychotic Disorders: In psychoses, possession beliefs may occur as delusions within a broader psychotic presentation, with other symptoms such as persistent hallucinations, disorganized thinking, and negative symptoms. In 6B63, symptoms are episodic, limited to trance states, and there are no persistent psychotic symptoms between episodes.

Trauma-related disorders: Dissociative states may occur in the context of complex PTSD, but without the specific narrative of possession by an external entity. Differentiation is based on the presence or absence of the experience of identity substitution by a possessing agent.

8. Differences with ICD-10

Equivalent ICD-10 code: In ICD-10, the closest concept is coded as F44.3 - Trance and possession disorders. However, ICD-10 did not clearly differentiate between trance disorder (without possession) and trance and possession disorder.

Main changes in ICD-11:

Conceptual separation: ICD-11 created two distinct codes—6B62 for Trance disorder and 6B63 for Trance and possession disorder—recognizing that they are related but clinically distinct phenomena. This separation allows for greater diagnostic precision.

Emphasis on cultural context: ICD-11 more explicitly emphasizes that the diagnosis should not be applied to experiences that are part of accepted collective cultural or religious practices. The definition specifies that the state must be "involuntary and unwanted" and "not accepted as part of a collective cultural or religious practice," providing clearer guidance to avoid pathologization of normative cultural practices.

More detailed exclusion criteria: ICD-11 provides a more comprehensive list of conditions to be excluded, specifically including hypnagogic/hypnopompic states, exhaustion, and withdrawal effects, which were not explicitly mentioned in ICD-10.

Minimum duration for single episode: ICD-11 specifies that, if the diagnosis is based on a single episode, it must last "at least several days," providing clearer temporal guidance that was absent in ICD-10.

Practical impact of these changes:

The separation between 6B62 and 6B63 allows clinicians to make more precise distinctions, which may influence therapeutic approaches. The increased emphasis on cultural context helps prevent inappropriate diagnoses in populations where trance practices are culturally normative, reducing the potential for stigmatization and inappropriate interventions.

More detailed exclusion criteria facilitate differential diagnosis, particularly important in contexts where substance use or medical conditions may mimic dissociative symptoms. The specification of minimum duration for single episodes helps distinguish genuine dissociative disorders from transient reactions to acute stress.

For research and epidemiological purposes, these changes allow for more precise studies on the prevalence and specific characteristics of different types of dissociative disorders, potentially leading to better etiological understandings and therapeutic interventions.

9. Frequently Asked Questions

How is Trance and Possession Disorder diagnosed?

The diagnosis is essentially clinical, based on detailed psychiatric evaluation. The process involves comprehensive clinical interview exploring the nature of episodes, frequency, duration, context of occurrence, and functional impact. It is fundamental to obtain detailed description of the patient's subjective experience during episodes, particularly regarding the sensation of being controlled by an external entity.

The evaluation should include complete history to identify possible precipitants, such as traumatic events or significant stressors. Standardized instruments such as the Dissociative Experiences Scale can assist in identifying dissociative symptoms. Crucially, medical and neurological evaluation is necessary to exclude organic causes, including neuroimaging studies and electroencephalogram when indicated.

Cultural evaluation is an essential component, exploring the patient's religious and cultural context to determine whether experiences occur within culturally sanctioned practices. Information from family members or other collateral sources can be valuable for corroborating the nature and impact of episodes.

Is treatment available in public health systems?

The availability of specialized treatment for dissociative disorders varies considerably among different regions and health systems. In many public health systems, basic mental health services are available, but professionals with specific expertise in dissociative disorders may be more limited.

Treatment generally involves specialized psychotherapy, particularly trauma-focused approaches when there is associated traumatic history. Cognitive-behavioral therapy, trauma-focused therapy, and stabilization techniques are commonly used. In some cases, medications may be prescribed for comorbid symptoms such as anxiety or depression, although there is no specific medication for the dissociative disorder itself.

Patients should seek mental health services through their local systems, requesting evaluation by professionals with experience in dissociative disorders when possible. In areas with limited resources, generalist mental health professionals can provide supportive treatment while consulting specialized literature or seeking supervision from specialists.

How long does treatment last?

The duration of treatment is highly variable and depends on multiple factors, including symptom severity, presence of underlying trauma, psychiatric comorbidities, patient's personal resources, and treatment response. It is not possible to establish a standardized timeline applicable to all cases.

Some patients may experience significant improvement within months with appropriate intervention, while others may require more prolonged treatment extending over years, particularly when there is underlying complex trauma or multiple comorbidities. Treatment generally involves phases, beginning with stabilization and development of emotional regulation skills, progressing to processing of traumatic experiences when applicable, and finally focusing on integration and relapse prevention.

Session frequency also varies, potentially being weekly initially and gradually reducing as the patient improves. Long-term follow-up may be necessary even after symptom remission to monitor and prevent recurrences.

Can this code be used on medical certificates?

Yes, code 6B63 can be used in official medical documentation, including certificates, when appropriate. However, considerations regarding confidentiality and stigma should be carefully weighed. In some contexts, it may be appropriate to use more general terminology such as "dissociative disorder" in documentation that will be widely shared, reserving the specific code for confidential medical records.

The decision regarding level of detail in certificates should be discussed with the patient, considering practical needs (such as justifying work absences or requesting accommodations) against concerns about privacy and potential discrimination. In many situations, it is sufficient to attest that the patient has a medical condition requiring treatment and/or leave, without specifying the exact diagnosis.

For purposes of disability benefits or workplace accommodations, more detailed documentation may be necessary, but should be provided directly to appropriate professionals (such as examining physicians) through confidential channels.

Is there a difference between spiritual possession and the disorder?

This is an absolutely critical distinction. Experiences of possession or trance that occur within sanctioned cultural or religious contexts, are voluntary or desired, do not cause significant distress, and do not impair functioning do not constitute mental disorder. Many religious and cultural traditions around the world incorporate ritualistic practices involving trance or possession states as valued components of spiritual expression or healing.

The disorder is diagnosed specifically when: (1) episodes are involuntary and unwanted, (2) cause significant distress to the individual, (3) result in significant functional impairment, and (4) are not part of accepted cultural/religious collective practice. Frequently, individuals with the disorder report that experiences are terrifying, uncontrollable, and severely interfere with their lives, contrasting markedly with ritualistic experiences that are typically limited to specific contexts, culturally structured, and positively integrated into the person's life.

Health professionals should have cultural sensitivity to make this distinction appropriately, avoiding pathologizing legitimate cultural practices while ensuring that individuals with genuine suffering receive appropriate care.

Is the disorder related to trauma?

There is frequently, although not invariably, an association between dissociative disorders, including 6B63, and history of trauma, particularly trauma in childhood or adolescence. Research suggests that traumatic experiences may contribute to the development of dissociative symptoms as a coping mechanism for intolerable situations.

However, not all individuals with Trance and Possession Disorder have an identifiable history of significant trauma, and not all people who experience trauma develop dissociative disorders. Multiple factors—including genetic predisposition, neurobiological factors, cultural context, social support, and individual characteristics of resilience—interact to determine whether and how dissociative symptoms develop.

When associated trauma is present, treatment frequently needs to address both dissociative symptoms and underlying traumatic experiences through trauma-focused therapeutic approaches. Even in the absence of clear trauma, psychotherapeutic interventions can help develop emotional regulation skills and reduce dissociative symptoms.

Can children develop this disorder?

Although dissociative disorders can occur in children and adolescents, diagnosis of Trance and Possession Disorder in this population requires special caution. Children have active imagination and may engage in fantasy play that includes assuming different identities or characters, which is part of normal development and should not be pathologized.

To diagnose the disorder in children, episodes must be clearly distinct from normal imaginative play, be involuntary and cause distress to the child, and result in significant functional impairment. Careful evaluation by a professional with expertise in child mental health is essential.

Additionally, cultural considerations are particularly important when evaluating children, as in some cultures, children may participate in ritualistic practices involving altered states of consciousness as part of their cultural socialization, which does not constitute disorder.

When genuine dissociative symptoms are identified in children, careful investigation of possible trauma, abuse, or neglect is important, as dissociative symptoms in children are frequently associated with adverse experiences. Early intervention with age-appropriate therapy can be particularly beneficial.

Can people with this disorder have a normal life?

With appropriate treatment, many individuals with Trance and Possession Disorder experience significant symptom improvement and can achieve satisfactory functioning in their lives. Prognosis varies considerably depending on factors such as symptom severity, duration of disorder before treatment, presence of underlying complex trauma, psychiatric comorbidities, available social support, and access to specialized treatment.

Some individuals achieve complete symptom remission with treatment, while others may continue experiencing symptoms to a lesser degree but develop management skills that allow adequate functioning. Factors associated with better prognosis include early identification and treatment, absence of severe comorbidities, good social and family support, and active engagement in treatment.

It is important that individuals with this disorder know that recovery is possible and that many people with dissociative disorders are able to return to work, maintain meaningful relationships, and engage in valued activities. Treatment focused not only on symptom reduction but also on development of life skills, strengthening of relationships, and pursuit of personal goals contributes to more positive outcomes and improved quality of life.

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Note: This article provides information for educational purposes and does not substitute for evaluation and guidance from qualified health professionals. Diagnosis and treatment of dissociative disorders should be conducted by professionals with appropriate training in mental health.

External References

This article was prepared based on reliable scientific sources:

1. 🌍 WHO ICD-11 - Trance and possession disorder
2. 🔬 PubMed Research on Trance and possession disorder
3. 🌍 WHO Health Topics
4. 📋 NICE Mental Health Guidelines
5. 📊 Clinical Evidence: Trance and possession disorder
6. 📋 Ministry of Health - Brazil
7. 📊 Cochrane Systematic Reviews

References verified on 2026-02-03