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Conversion disorder
Definition:
The conversion of emotional distress or unconscious conflict into a physical symptom. It is one of the general class of Somatoform disorders.

Alternative Names:
Hysterical neurosis

Causes, incidence, and risk factors:

The symptom onset of this disorder is usually very sudden and follows a stressful experience. The loss of function may symbolize the underlying conflict associated with it. Psychodynamic theory interprets the cause of the symptoms as a defense mechanism that absorbs and neutralizes the anxiety generated by an unacceptable impulse or wish. Risk factors include a history of histrionic personality disorder or dependent personality disorder.
Symptoms:

A conversion disorder is characterized by the loss of a bodily function, for example blindness, paralysis, or the inability to speak. The loss of physical function is involuntary, but diagnostic testing does not show a physical cause for the dysfunction.

  • Sudden onset of a debilitating symptom
  • History of a recent psychological conflict that is resolved through the development of the symptom
  • Lack of appropriate concern usually associated with a severe symptom
Signs and tests:

A physical examination is performed to rule out physical cause for loss of function. Specific diagnostic testing related to the exhibited symptom may be warranted to rule out a physical cause.
Treatment:

Psychiatric treatment is recommended to help the person understand the underlying psychological conflict. The person needs to know there is no organic cause for the symptom. 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.
Expectations (prognosis):

Relief of the symptom occurs with effective treatment. Usually the symptom is not life-threatening, but complications as a result of the symptom can develop and be debilitating, (for example, muscle wasting through disuse of a body part, or wasting and weight loss due to gastrointestinal symptoms).
Complications:

Complications can result from disuse of a body part or system. Seizure-like disorders referred to as pseudoseizures develop in some individuals.
Calling your health care provider:

Call for an appointment with your health care provider if multiple diagnostic work-ups have found no cause for the symptoms.
Review Date: 5/18/2001
Reviewed By: Christos Ballas, M.D., Department of Psychiatry, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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