Conversion disorder

Conversion disorder

A conversion disorder causes patients to suffer from neurological symptoms, such as numbness, blindness,paralysis, or fits without a definable organic cause. It is thought that symptoms arise in response to stressful situations affecting a patient's mental health. Conversion disorder is considered a psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5).

Formerly known as "hysteria",

Signs and symptoms

Motor symptoms or deficits:

• Impaired coordination or balance
• Weakness/paralysis of a limb or the entire body (hysterical paralysis or motor conversion disorders)
• Impairment or loss of speech (hysterical aphonia)
• Difficulty swallowing or a sensation of a lump in the throat
• Urinary retention
• Psychogenic non-epileptic seizures or convulsions
• Persistent dystonia
• Tremor, myoclonus or other movement disorders
• Gait problems (astasia-abasia)
• Loss of consciousness (fainting)

Sensory symptoms or deficits:

• Impaired vision (hysterical blindness), double vision
• Impaired hearing (deafness)
• Loss or disturbance of touch or pain sensation

Treatment

There are a number of different treatments that are available to treat and manage conversion syndrome. While occasionally symptoms do disappear on their own, many people benefit from a variety of treatment options. Treatments for conversion syndrome include hypnosis, psychotherapy, physical therapy, stress management, and transcranial magnetic stimulation. Treatment plans will consider duration and presentation of symptoms and may include one or multiple of the above treatments. This may include the following:

1.     Explanation. This must be clear and coherent as attributing physical symptoms to a psychological cause is not accepted by many educated people in western cultures. It must emphasize the genuineness of the condition, that it is common, potentially reversible and does not mean that the sufferer is psychotic. Taking an etiologically neutral stance by describing the symptoms as functional may be helpful but further studies are required. Ideally, the patient should be followed up neurologically for a while to ensure that the diagnosis has been understood.

2.     Physiotherapy where appropriate;

3.     Occupational Therapy to maintain autonomy in activities of daily living;

4.     Treatment of comorbid depression or anxiety if present.

There is little evidence-based treatment of conversion disorder. Other treatments such as cognitive behavioral therapy, hypnosis, EMDR, and psychodynamic psychotherapy, EEG brain biofeedback need further trials. However, Psychoanalytic treatment has been shown to help find a correlation between painful emotions/memories and Conversion disorder. Psychoanalytic treatment also attempts to express these feelings to help lighten symptoms.

Reference link:

·         https://en.wikipedia.org/wiki/Conversion_disorder