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I don't actually think Knox's 4th specifically prohibits a person having a disease. There would probably have to be some evidence of course if a person isn't actively suffering from its effects in a way that is obvious.
Agatha Christie was always fond of people with conditions (usually physical of course), or people faking conditions, but it was always usually very clearly presented and central to the plot. The problem with a mental disorder is that a bad writer can always just write the person normally then pull out the crazy whenever they want.
It's harder to get around the guy with pneumonia killing someone at night without hacking up a storm and waking half the place, but it's a lot easier to be like "Surprise! He was schizophrenic!" without even stopping to consider how difficult it would be for a person like that to fit in and act normally the majority of the time.
If DID were involved somehow in Umineko, one would be forced to question the good sense of the people involved in covering it up and managing it, especially to have that person working on the day of the family conference, when stress and alterations to routine (routine can really help a person with a mental disorder, if it's maintained) would be at their peak.
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