A conversion disorder is a condition in which a person develops certain physical symptoms, such as paralysis or visual impairment, in response to severe psychological stress. No physical cause can be found for these symptoms.
This disorder occurs most often among people 10 to 35 years old. Among older people, there is a much greater chance that unexplained symptoms are caused by a medical problem. Usually, the disorder lasts only for a few weeks or months. During that time, a person may be unable to work or even carry out daily activities.
Conversion disorder is not thought to make a person more vulnerable to real health problems. Many people who suffer conversion symptoms, however, have medical problems as well.
This disorder starts suddenly. Its signs and symptoms may include: paralysis of an arm or legvisual impairment, or blindnessinability to speakhearing impairment, or deafnessseizuresfalling downnumbnessvisual changes, such as double visiondifficulty swallowingsevere trembling
Experts believe that the symptoms are caused by the "conversion" of emotional distress into physical distress. The disorder is more common in women than men. Certain factors raise a person's risk for this disorder, including: having a family member with the disorderhaving been sexually abused as a child having a very stressful home or work lifebelonging to a lower socioeconomic class
Psychotherapy that helps a person recognize and cope with stressful situations may help prevent this disorder. If a person has already had an episode, learning about the problem and ways to deal with it can help prevent recurrences.
A conversion disorder may be suspected if a person suddenly has any of the symptoms listed above. The diagnosis is made if a recent, severe psychological stressor exists and no physical cause for the symptom can be found. With careful evaluation, however, as many as 20% to 50% of people initially diagnosed with this disorder are eventually found to have a physical cause for their symptoms.
Most people who are not treated have repeated episodes. This results in unwarranted medical bills and potentially risky procedures. Family members may get angry and frustrated with the person, too. That increases family stresses and can raise the risk for divorce. Children and teens who experience conversion symptoms often have trouble at school and fall behind their peers.
This disorder is not contagious. There are no risks to others.
Most conversion episodes will only end with support and reassurance from healthcare professionala and family members. If the symptoms do not go away within a few weeks, psychotherapy is usually the best treatment. During therapy, the person is encouraged to: discuss stressful events and situationslearn how the disorder developsfind healthy ways to cope with stress
Hypnosis has also been used successfully. While hypnotized, a person can be told that the symptom will soon disappear. A similar approach is to talk to the person after he or she takes a relaxing medication. This sometimes helps a therapist identify the underlying conflict. Someone who has been sexually abused usually needs help to overcome the painful effects of this trauma.
Psychotherapy rarely has side effects. Occasionally, a person feels overwhelmed by anxiety if confronted with too many stressful thoughts and memories at once.
If treatment is successful, a person usually has long periods without symptoms. Some people never develop symptoms again. Continued work with a therapist can help a person avoid later episodes by: resolving the problems that prompted the symptomsrecognizing early signs of stress that might lead to an episode
Conversion disorder can recur even after effective treatment. Usually, episodes occur during or after a serious life stress. Ongoing psychotherapy can reduce the risk of recurrence.
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Diagnostic and statistical manual of mental disorders, fourth edition. (1994) Washington D.C: American Psychiatric Press.