A meta-analysis of 25,000 people found that compulsive daydreaming is strongly linked to depression, OCD, and trauma, but psychiatry still does not officially recognize it as a condition
Most people daydream. A few minutes between tasks, a brief escape during a commute, a pleasant drift into imagination before sleep. It is normal, often useful, sometimes necessary. But there is a subset of the population for whom daydreaming is none of these things. For them, it is a compulsion. They spend hours each day immersed in intricate fictional worlds, complete with recurring characters, ongoing plotlines, and emotional stakes that feel as real as anything happening in their actual lives. They pace while they do it, or sway, or gesture, using repetitive physical movement to sustain the trance. They use music as a trigger. They cannot stop when they need to, and they lose time they needed for work, relationships, and basic obligations to a habit they did not choose and cannot explain to the people around them.
Psychiatry has a name for this: maladaptive daydreaming. What psychiatry does not have is a diagnostic category for it. It does not appear in the DSM. It does not appear in the ICD. Clinicians who encounter patients describing these symptoms typically redirect them toward more familiar diagnoses, ADHD, OCD, dissociative disorder, depression, all of which may be present but none of which quite captures what the patient is actually describing. And so hundreds of thousands of people across the world have turned to internet forums instead, seeking from strangers the validation and recognition that the mental health system has withheld.
A new meta-analysis published in the International Journal of Psychology is now the most statistically comprehensive argument yet that this recognition is overdue.
What the data shows across 24,977 people
The research team, led by Eli Somer of the University of Haifa, the clinical psychologist who first named and described maladaptive daydreaming in 2002, synthesized findings from 40 independent studies published over the past two decades. Together those studies encompassed 24,977 participants. The goal was straightforward: determine whether maladaptive daydreaming consistently co-occurs with recognized mental health conditions across diverse populations, because consistent overlap at this scale is precisely the kind of evidence that warrants formal clinical recognition.
The results were not ambiguous. Across the combined dataset, maladaptive daydreaming showed strong positive associations with depression, anxiety, and dissociation. It was substantially linked to obsessive-compulsive disorder and to ADHD. Associations also emerged with trauma history, autism spectrum disorder, psychotic symptoms, and broad measures of general psychopathology. The pattern held across thousands of participants drawn from different countries, age groups, and research methodologies.
Beyond diagnosable conditions, the data also documented links to a wider landscape of psychological struggle. People who reported compulsive fantasizing also reported significant difficulties regulating their emotions, elevated levels of loneliness, shame, and problematic internet use, higher rates of physical symptoms without a clear medical explanation, and lower scores across measures of life satisfaction, general wellbeing, and sense of meaning.
Why psychiatry has not acted
The gap between what patients experience and what clinical systems acknowledge is not a new problem in mental health, but it is particularly sharp in the case of maladaptive daydreaming. The condition was first described only in 2002, making it young by psychiatric standards. Research has accumulated steadily since then, but the pace of formal recognition in diagnostic systems moves slowly, typically requiring decades of evidence, multiple independent research groups, and a clear consensus on diagnostic criteria.
What complicates matters further is the symptom overlap. Many people who experience maladaptive daydreaming do also meet criteria for ADHD, OCD, or dissociative disorders. Clinicians encountering a patient who describes losing hours to uncontrollable fantasy have a menu of recognized diagnoses available that partially explain what they are hearing. The temptation to fit a familiar label rather than document an unfamiliar one is understandable, and it means that patients who seek help often receive treatment aimed at the wrong target, or partial treatment aimed at comorbid conditions while the core problem goes unaddressed.
The internet has created an unintended compensation for this gap. Forums dedicated to maladaptive daydreaming have attracted hundreds of thousands of members, many of whom describe years or decades of trying to explain their experience to therapists, receiving dismissal, and eventually finding that strangers online understood immediately what clinicians could not. The existence of these communities is itself a form of epidemiological signal: the number of people seeking peer support for a condition suggests a prevalence that formal clinical systems are not equipped to measure because they lack the diagnostic infrastructure to count it.
What maladaptive daydreaming actually looks like
For people who do not experience it, the description of maladaptive daydreaming can sound like an intensified version of normal imagination. The distinction lies not in the vividness of the fantasy but in the relationship the person has with it.
Normal daydreaming is under volitional control. A person can choose to begin, sustain, and end it. Maladaptive daydreaming is not. The fantasy intrudes. It is triggered by music, by physical movement, by environmental cues, and once triggered it demands to continue. People describe feeling pulled back into the fantasy world against their intention, losing track of time in a way that is more similar to dissociation than to pleasant distraction.
The content of the fantasies is typically elaborate and persistent. Unlike ordinary daydreaming, which tends toward loosely connected imagery, maladaptive daydreamers describe structured narrative worlds with histories, characters, and ongoing storylines that develop over months or years. The emotional investment is substantial: many people describe grief when characters in their inner world die or storylines end, or anxiety when real-world obligations prevent them from returning to the fantasy they feel they are neglecting.
The physical movements that frequently accompany the daydreaming are distinctive enough that they can alarm family members who witness them, further isolating people who are already reluctant to describe the behavior to anyone outside an anonymous forum.
The case for recognition
Somer and colleagues frame their meta-analysis explicitly as an argument for including maladaptive daydreaming in formal diagnostic systems. The statistical case has now reached a scale that is difficult to dismiss: 40 studies, nearly 25,000 participants, consistent associations with recognized psychopathology across every major category of mental health difficulty. The pattern is not the signature of a harmless quirk or an exaggerated version of normal imagination. It is the signature of a condition that travels with serious psychological distress and impairs functioning across multiple life domains.
Formal recognition would have immediate practical consequences. It would enable clinicians to accurately identify and document the condition rather than redirect patients toward partial diagnoses. It would create the diagnostic infrastructure needed to estimate true prevalence in the general population. It would open the condition to systematic treatment research, since no clinical trials have yet examined which therapeutic approaches are most effective for maladaptive daydreaming specifically. And it would give the hundreds of thousands of people currently managing this condition through internet forums access to the professional help they have been seeking.
The 2002 paper that named maladaptive daydreaming described a condition that a small group of researchers believed was real, clinically significant, and underrepresented in psychiatric literature. The meta-analysis published in 2026 describes the same condition with data from 24,977 people and a two-decade body of converging evidence. The question of whether psychiatry will act on that evidence is no longer about whether the condition exists. It is about how long formal systems take to catch up with what patients have known for years.
Source
Eli Somer, Oren Herscu, Muthanna Samara, Hisham M. Abu-Rayya. “Maladaptive daydreaming and psychopathology: A meta-analytic review.” International Journal of Psychology, 2026.
DOI: 10.1002/ijop.70027
