Conversion disorder

Conversion disorder is a psychiatric condition in which emotional distress or unconscious conflict are expressed through physical symptoms.

Conversion disorder is one of several types of somatoform disorders in which psychological problems produce physical symptoms.

These disorders have been highly stigmatized, with many physicians telling patients that the problem is "all in your head." Research on the connection between mind and body is increasing our understanding of these disorders and should reduce the stigma as it becomes clear that these conditions are real, cause real distress, and cannot be turned on and off at will.

The onset of symptoms in this disorder is usually very sudden and follows a stressful experience. Loss of function, such as the inability to move a limb, may unconsciously symbolize the underlying conflict associated with the experience. Medical illness is a major risk factor for conversion disorder. Studies have shown that many patients suspected of having the disorder actually have an underlying medical illness. Many patients with this disorder also have an dissociative or personality disorder.

The symptoms of conversion disorder involves the involuntary loss of one or more bodily functions resulting in, for example, blindness, paralysis, or the inability to speak. Diagnostic testing does not show a physical cause for the dysfunction.

Some of the common signs of conversion disorder include:

• The sudden onset of a debilitating symptom
• A history of a recent psychological conflict that is resolved through the development of the symptom
• A lack of concern that is usually associated with a severe symptom

A physical examination is performed to rule out physical causes for the loss of function. Specific diagnostic testing related to the symptom is warranted to rule out a physical cause.

Psychiatric treatment is recommended to help the person understand the underlying psychological conflict. The integrity of the affected body part or function must be maintained until the conflict is resolved and the symptoms disappear. For example, paralyzed limbs must be exercised to avoid muscle wasting.

Symptoms usually last for days to weeks and may resolve spontaneously. Usually the symptom itself is not life-threatening, but the development of complications as a result of the symptom can be debilitating.

Call for an appointment with your health care provider if you or someone you know has symptoms suggestive of conversion disorder.