Conversion

Conversion disorder (CD), also known as functional neurological symptom disorder, is a complex psychiatric condition characterized by neurological symptoms that are inconsistent with or cannot be fully explained by medical or neurological conditions. The symptoms can affect motor or sensory functions, leading to significant distress or impairment in social, occupational, or other important areas of functioning. The exact cause of conversion disorder is unknown, but it is thought to involve a combination of psychological, genetic, and environmental factors.

Symptoms

Symptoms of conversion disorder can vary widely and may affect motor or sensory skills. Common symptoms include:

• Abnormal gait
• Paralysis or weakness
• Non-epileptic seizures
• Sensory loss (e.g., blindness, deafness)
• Speech disorders (e.g., dysphonia, mutism)
• Tremors or dystonia

These symptoms are not intentionally produced and can cause significant distress or impairment in daily functioning.

Diagnosis

The diagnosis of conversion disorder is primarily clinical and based on the exclusion of neurological or medical conditions. Key diagnostic criteria, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), include:

• The presence of one or more symptoms of altered voluntary motor or sensory function.
• Clinical findings provide evidence of incompatibility between the symptom and recognized neurological or medical conditions.
• The symptom or deficit is not better explained by another medical or mental disorder.
• The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Additional tests and assessments may be conducted to rule out other conditions, including neurological examinations, imaging studies, and psychiatric evaluations.

Treatment

Treatment of conversion disorder focuses on improving symptoms and functional abilities. A multidisciplinary approach is often most effective, involving:

• Psychotherapy (e.g., cognitive-behavioral therapy)
• Physical therapy for motor symptoms
• Occupational therapy to improve daily functioning
• Medication may be used to treat co-occurring conditions or symptoms, such as depression or anxiety.

Education about the disorder and its management is also an important part of treatment.

Prognosis

The prognosis for individuals with conversion disorder varies. Some individuals may experience a resolution of symptoms, while others may have persistent or recurrent symptoms. Early diagnosis and treatment can improve the prognosis.

Epidemiology

Conversion disorder can occur at any age but is most commonly diagnosed in late childhood to early adulthood. It appears to be more common in females than in males. The prevalence of conversion disorder is estimated to be 2 to 5 cases per 100,000 in the general population.

History

The concept of conversion disorder dates back to the work of Sigmund Freud, who proposed that unresolved psychological conflicts could manifest as physical symptoms. The term "conversion" comes from Freud's notion of converting psychological distress into physical symptoms.

See Also

• Somatoform disorders
• Dissociative disorders
• Psychogenic non-epileptic seizures
• Factitious disorder