Conversion Disorder

Conversion Disorder Overview, Treatment, Cause, Symptoms, Medication

Conversion disorder is a psychiatric condition in which emotional distress or unconscious conflict are expressed through physical symptoms.

Conversion disorder is included as a somatoform disorder under the general classification of hysterias in the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, Fourth Edition ( DSM-IV ).

Conversion Disorder is a somatoform disorder that involves motor or sensory problems that would "suggest" a neurological condition. Psychological factors, however, can be shown to be associated with the onset or worsening of symptoms.

People with conversion disorder express emotional conflict or severe anxiety due to stress through physical symptoms that affect voluntary or sensory function. These may include problems with walking or moving an arm, or even blindness. This disorder generally occurs in people whose usual coping methods are overwhelmed.

According to psychodynamic theory, conversion symptoms seem to be maintained by operant conditioning. The person derives "primary gain" by keeping an internal conflict or need out of awareness. The symptom has a symbolic value that is a representation and partial solution of a deep-seated psychological conflict.

Diagnostic criteria for conversion disorder

Diagnostic criteria for conversion disorder as defined in the DSM-IV are as follows:

• One or more symptoms or deficits are present that affect voluntary motor or sensory function that suggest a neurologic or other general medical condition.
• Psychologic factors are judged to be associated with the symptom or deficit because conflicts or other stressors precede the initiation or exacerbation of the symptom or deficit.
• The symptom or deficit is not intentionally produced or feigned (as in factitious disorder or malingering).
• The symptom or deficit, after appropriate investigation, cannot be explained fully by a general medical condition, the direct effects of a substance, or as a culturally sanctioned behavior or experience.
• The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or warrants medical evaluation.
• The symptom or deficit is not limited to pain or sexual dysfunction, does not occur exclusively during the course of somatization disorder, and is not better accounted for by another mental disorder.

Symptoms of Conversion Disorder

The symptoms of conversion disorder involve the loss of one or more bodily functions. These may include blindness, paralysis or the inability to speak. The loss of physical function is involuntary and diagnostic testing does not show a physical cause for the dysfunction.

Treatment of Conversion Disorder

Psychiatric treatment is recommended to help the person understand the underlying psychological conflict. The integrity of the affected body part or function must be maintained until the conflict is resolved and the symptoms usually disappear. For example, paralyzed limbs must be exercised to avoid muscle wasting.

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Site last updated: March 4, 2008

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