Conversion Disorder

Conversion Disorder

Conversion disorder is a form of mental disorder wherein an individual manifests physical symptoms such as paralysis and blindness which medical evaluation cannot elucidate. Most of the people who experience the disorder has another type of psychiatric problem like generalized anxiety and depression or have history of recent stressful situation. ^[1]

Epidemiology

Women are more affected with 2-10:1 ratio. Usual patients are in their adolescence or middle age years. One report suggests that yearly incidence is 11 per 100,000 in Iceland. Most patients have low socioeconomic status, rural residents and have a history of sexual or physical abuse. ^{[1] [2]}

Causes

The symptoms often show up after a stressful episode as a result of emotional conflict. Theories imply that patients derive primary and secondary gain. With the first one, they are able to convey a conflict that has been unconsciously held back. With the secondary one, the patients can avoid unlikable situations or in other circumstances, they are able to get social support that would otherwise be unattainable.  Risk factors include having another medical illness, having another mental disorder, history of physical or sexual abuse, low socioeconomic status, having family members with conversion disorder or long term medical illness and having a personality disorder. ^[2][3]

Signs and Symptoms

The symptoms are involuntary. Contrary to some beliefs, the patient is nor pretending or acting out. The symptoms that the patient is complaining are real however do not correlate with any known medical illness. Most frequently reported symptoms are lack of coordination and balance, difficulty or being unable to move the arm or legs, loss of sensation, inability to speak, seizures, blindness and deafness. Some patients also experience vomiting, abdominal pain, foreign sensation in the throat and problems with swallowing. Some may develop loss of pain sensation or feeling of objects crawling underneath the skin. ^[4]

Diagnosis

After getting the medical history, the physician often performs a physical examination. Laboratory tests may be done and typically results cannot point out the physical cause for the symptoms. A set of diagnostic criteria for conversion disorder must be fulfilled for a case to be labeled as conversion disorder. ^[1]

Treatment

There is no single best treatment. Supportive measures are usually advised. If there is depression or anxiety, medications may be given. Depending on the case, psychotherapy or physical therapy may be helpful. ^[1]

References:

1.      http://www.intelihealth.com/IH/ihtIH/c/9339/9759.html

2.      http://emedicine.medscape.com/article/287464-overview#a0199

3.      http://www.nlm.nih.gov/medlineplus/ency/article/000954.htm

4.      http://www.med.nyu.edu/content?ChunkIID=96743

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