Maladaptive daydreaming: Towards a nosological definition

Maladaptive daydreaming (MD) is an excessive and vivid fantasy activity that interferes with individual's normal functioning and can result in severe distress. Research has shown that MD is a clinical condition associated with a number of personal, interpersonal and behavioral problems. Therefore, a need exists to differentiate MD from other mental activities that involve an excessive or otherwise problematic use of fantasy. These include, among others, daydreaming, mind wandering, dissociative absorption, fantasy proneness, sluggish cognitive tempo, lucid dreaming, and autistic fantasy. In this article, we examine the commonalities and differences between MD and these mental activities, to promote a better understanding of the MD phenomena and their specificity, and to foster the quality of its assessment in clinical settings. A clinical case study is employed to elucidate our analysis and to demonstrate the differential diagnosis of MD.