2. 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.
3. 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
Ch 7.2
4. Presentation:
Conversion disorder can present with motor or sensory symptoms including any
of the following:
Motor symptoms or deficits:
1. Impaired coordination or balance
2. 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 throat
5. Urinary retention
6. Psychogenic non-epileptic seizures or convulsions
7. Fixed dystonia unlike normal dystonia
8. Tremor, myoclonus or other movement disorders
9. Gait problems (Astasia-abasia)
10. Syncope (fainting)
5. 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
6. 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
7. There is little evidence-based treatment of
conversion disorder
Treatment may include the following:
1. Physiotherapy where appropriate
2. Occupational Therapy to maintain autonomy
in activities of daily living
3. 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.
