Conversion Disorder

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This it the word I recall hearing today Conversion Somato....I do not

feel like I have much help now with them thinking I'm a nut case. RC

Refer to conditions of use

Conversion Disorder

Whilst " hysterical " blindness, paralysis, anesthesia, dysphagia, and

gait disturbance have been described for many years, This patient

confronts an acute stressor that creates a psychic conflict, and the

physical symptom(s) serve as the resolution for the conflict. The

patient may repress the stressor or be unaware of its impact. Failure

to recognize and treat this early in the course may lead to symptoms

which eventually become harder or impossible to cure. This disorder

may occur at any age, either gender, any personality. 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.

At least one symptom or deficit of sensory or voluntary motor

function suggests a neurological or general medical condition.

It is not limited to pain or sexual dysfunction.

Appropriate investigation does not identify a neurological or

general medical condition or the direct effects of substance use that

can fully explain it.

Conflicts or other stressors that precede the onset or worsening of

this symptom suggest that psychological factors are related to it.

The patient doesn't consciously feign the symptoms for material gain

(Factitious Disorder) or to occupy the sick role (Malingering).

It is not a culturally sanctioned behavior or experience.

It is serious enough to produce at least 1 of:

warrants medical evaluation, or

causes distress that is clinically important, or

impairs social, occupational or personal functioning

It does not occur solely during Somatization Disorder, and no other

mental disorder better explains it.

Symptom Groupings:

Sensory Symptoms: These include anesthesia, excessive sensitivity to

strong simulation (hyperanesthesia), loss of sense of pain

(analgesia), and unusual symptoms such as tingling or crawling

sensations.

Motor Symptoms: In motor symptoms, any of the body's muscle groups

may be involved: arms, legs, vocal chords. Included are tremors, tics

(involuntary twitches), and disorganized mobility or paralysis.

Visceral Symptoms: Examples are trouble swallowing, frequent

belching, spells of coughing or vomiting, all carried to an uncommon

extreme. In both sensory and motor symptoms, the areas affected may

not correspond at all to the nerve distribution in the area.

Specify type of symptom or deficit:

With Motor Symptom or Deficit.

With Seizures or Convulsions.

With Sensory Symptom or Deficit.

With Mixed Presentation.

Associated Features:

Depressed Mood.

Somatic or Sexual Dysfunction.

Guilt or Obsession.

Anxious or Fearful or Dependent Personality.

Differential Diagnosis:

Some disorders have similar or even the same symptom. The clinician,

therefore, in his diagnostic attempt has to differentiate against the

following disorders which he needs to rule out to establish a precise

diagnosis.

Generalized Anxiety Disorder.

Histrionic Personality Disorder.

Dependent personality Disorder.

Cause:

The symptom onset of this disorder is usually very sudden and follows

a stressful experience. These disorders may be best thought of as

disturbances of illness perception or need. They are paradigms of

mind-body interactions and of the critical role of mental factors in

the production of illness. Though the role of the mind in creating

and maintaining illness has been known since antiquity, terms such as

hysteria or psychosomatic illness have lost their meaning over time.

All illnesses are " psychosomatic: " they occur in an individual at a

particular psychological point in his/her life.

Treatment:

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.

Counseling and Psychotherapy [ See Therapy Section ]:

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.

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.

Complications can result from disuse of a body part or system.

Seizure-like disorders referred to as pseudoseizures develop in some

individuals.

Pharmacotherapy [ See Psychopharmacology Section ]

Anti Depressants.