Conversion Disorder

Conversion Disorder

Alternate Names

  • hysterical conversion

Definition

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.

What is going on in the body?

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.

Risks

What are the causes and risks of the condition?

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 disorder
  • having been sexually abused as a child
  • having a very stressful home or work life
  • belonging to a lower socioeconomic class

Prevention

What can be done to prevent the condition?

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.

Diagnosed

How is the condition diagnosed?

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.

Long Term Effects

What are the long-term effects of the condition?

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.

Other Risks

What are the risks to others?

This disorder is not contagious. There are no risks to others.

Treatments

What are the treatments for the condition?

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 situations
  • learn how the disorder develops
  • find 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.

Side Effects

What are the side effects of the treatments?

Psychotherapy rarely has side effects. Occasionally, a person feels overwhelmed by anxiety if confronted with too many stressful thoughts and memories at once.

After Treatment

What happens after treatment for the condition?

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 symptoms
  • recognizing early signs of stress that might lead to an episode

Monitor

How is the condition monitored?

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.

Sources

Martin RL and Yutzy SH.(1997) Somatoform Disorders. In: Psychiatry, Vol 2. Pages 1119-1155. Edited by Tasman A, Kay J, and Lieberman JA. Philadelphia: W.B. Saunders Company.

Martin RL and Yutzy SH.(1996) Somatoform Disorders. In: Synopsis of Psychiatry pages 547-572. Edited by Hales RH and Yudofsky SC. , Washington D.C.: American Psychiatric Press.

Diagnostic and statistical manual of mental disorders, fourth edition. (1994) Washington D.C: American Psychiatric Press.

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