CONVERSION DISORDER

PRESENTED BY: Anam Khan

Conversion disorder causes patients to suffer apparently neurological symptoms, such as numbness, blindness, paralysis, or fits, but without a neurological cause. It is thought that these problems arise in response to difficulties in the patient's life, and conversion is considered a psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV)

Formerly known as "hysteria", The term "conversion" has its origins in Freud's

doctrine that anxiety is "converted" into physical symptoms.

Conversion Disorder involves sensory or motor symptoms◦Not related to known physiology of the body E.g. glove anesthesia

◦Conversion symptoms appear suddenly◦Conversion symptoms are related to marked stress.

◦Mixed presentation .◦Popularized by Freud

Conversion Disorder

Ch 7.2

Presentation:Conversion disorder can present with motor or sensory symptoms including

any of the following:

Motor symptoms or deficits:1. Impaired coordination or balance2. Weakness/paralysis of a limb or the entire body (hysterical paralysis or

motor conversion disorders)3. Impairment or loss of speech (hysterical aphonia)4. Difficulty swallowing or a sensation of a lump in the throat5. Urinary retention6. Psychogenic non-epileptic seizures or convulsions7. Fixed dystonia unlike normal dystonia8. Tremor, myoclonus or other movement disorders9. Gait problems (Astasia-abasia)10. Syncope (fainting)

Sensory symptoms or deficits: Impaired vision (hysterical blindness) Double vision Impaired hearing (deafness) Loss or disturbance of touch or pain sensation Conversion symptoms typically do not conform to known

anatomical pathways and physiological mechanisms, but instead follow the individual's conceptualization of a condition. Typically, the less medical knowledge a person has, the more implausible are the presenting symptoms. Persons with more sophisticated medical knowledge tend to have more subtle symptoms and deficits that may closely simulate neurological or other general medical conditions

Acute cases◦Reassurance/appropriate rehabilitation ◦Psychotherapy

Conversion disorder clients seek help from physicians and resent referrals to psychotherapists◦Psychoanalytic therapy is not effective for conversion disorder

◦The cognitive-behavioral approach involves pointing out selective attention to physical sensations and discouraging the client from seeking medical assistance

MANAGEMENT/ TREATMENT

There is little evidence-based treatment of conversion disorder

Treatment may include the following:1. Physiotherapy where appropriate2. Occupational Therapy to maintain

autonomy in activities of daily living3. Treatment of comorbid depression or

anxiety if present.4. Other treatments such as cognitive

behavioral therapy, hypnosis, EMDR, and psychodynamic psychotherapy, EEG brain biofeedback need further trials.

Treatment