According to the psychodynamic model, the symptoms are a consequence of emotional conflict, with the repression of conflict into the unconscious. Conversion disorder is a rare condition in which your brain converts mental stress into physical symptoms. A brief summarize of conversion disorder treatments iaap. Keep in the program office or library for use by students, faculty, or staff. The original dsmiii category of somatoform disorders included somatization disorder, hypochondriasis, conversion disorder, psychogenic pain disorder, and a residual somatoform disorder category apa, 1980. A clinical approach to paediatric conversion disorder. Conversion disorder dsmtreatment for conversion disorder. Since doctors have conceptually and practically differentiated the symptoms from neurological organic disease it has been presumed to be a psychological. Treatment for conversion disorder typically consists of psychotherapy, physical therapy, andor medication. Case history and treatment of a conversion disorder tahira yousaf institute of professional psychology bahria university, karachi campus abstract the aim of the present study is to describe the case study and treatment of severe functional impairment in a nineteen year old young female adolescent with conversion disorder. An important characteristic differentiates conversion disorders from other stressrelated health problems.
So, although we present the treatments classified under the model which created them, never forget that in present psychology, therapies from different approaches are used together. Treatment will also be tailored to fit the specific symptoms experienced by the individual. In malingering the purpose is to avoid some unpleasantness, such as jail. The category of somatoform disorders was not officially recognized until the publication of dsmiii. It is sometimes applied to patients who present with neurological symptoms, such as numbness, blindness, paralysis, or fits, which are not consistent with a wellestablished organic cause, which cause significant distress, and can be traced back to a.
In this article, learn about the common symptoms and treatment. Somatic symptom and related disorders are those with distressing physical symptoms that are not fully explained by other medical, neurologic, or psychiatric disorders also known as somatization. Conversion disorder genetic and rare diseases information. Throughout its history, the etiology, diagnosis, and treatment of this disorder have been a subject of controversy. A conversion disorder can sometimes resolve either on its own or in treatment. However, its important to get treatment as soon as symptoms develop. Patients were in a wheelchair when not in therapy, and a physical therapy program was devised, using a treatment sequence based treatment of the analogous. Psychoeducation helps patients accept their symptoms as real, validates the diagnosis, and allows for treatment. The symptoms of conversion disorder dont typically last for more than a few weeks. The core feature of conversion disorder is a deficit or distortion in neurological functioning, or symptoms suggesting a general medical condition that is not referable to an organic lesion.
Conversion disorder is one of a group of psychological disorders called somatoform disorders. Conversion disorder conversion disorder is a specific form of somatization in which the patient presents with symptoms and signs that are confined to the voluntary central nervous system 5. Pdf treatment of a severe conversion disorder in a 10yearold. Treatment talk therapy and stress management training may help reduce symptoms. Conversion disorder australia pdf ppt case reports. Testing and diagnosis usually involves a neurologist, but may include a psychiatrist or other mental health professional. Its imperative that there be communication between treatment providers when treating conversion disorder. Learn more about the causes, symptoms, diagnosis, treatment, and outlook for conversion. Conversion disorder cd, or functional neurologic symptom disorder, is a diagnostic category used in some psychiatric classification systems. Conversion disorder, also called functional neurological disorder, is a condition in which abnormal movements or sensations spells, weakness, tremors are not due to injury or disease, but rather a result of a miscommunication of the nervous system and the body.
Symptoms of conversion disorder are not feigned or deliberately produced. In both these cases, in contrast to conversion disorder, the patient premeditates the symptoms and intentionally feigns them with a clearly conceived purpose in mind. Conversion disorders medication medscape reference. Conversion disorder american journal of psychiatry. Prominent involvement of truncal muscles arching and pelvic thrusting, as well as lateral rolling of head and body. Conversion disorder, as stated in the diagnostic and statistical manual of mental disorders, fourth edition, text revision dsmivtr, involves symptoms or deficits affecting voluntary motor or sensory function that suggest a neurologic or other general medical condition. Conversion symptoms suggest a physical disorder but are the result of psychological factors. Conversion disorder remains a diagnosis of exclusion.
She responded to treatment with valproate and sertraline. The cornerstone of treatment for conversion disorder is psychotherapy aimed at. Functional neurologic disorders a newer and broader term that includes what some people call conversion disorder feature nervous system neurological symptoms that cant be explained by a neurological disease or other medical condition. Conversion disorder is thought to be caused by the bodys reaction to a stressful. Conversion disorder is a disorder in which a person experiences blindness, paralysis, or other symptoms affecting the nervous system that cannot be explained solely by a physical illness or injury. History of broken relationships, alcoholism or drug addiction and school or social pressures. Symptoms usually begin suddenly after a period of emotional or physical distress or psychological conflict. Patients may express doubt, anger, and disappointment or seek different providers, which negatively affects the doctorpatient relationship. Conversion disorder functional neurological symptom disorder. There was treatment going on, clearly, but not in the same fashion as in europe. Conversion disorder cd is an uncommon but highly disabling condition in the paediatric.
Recognizing and treating conversion disorder journal of. An examination of the revised dsm5 criteria for conversion disorder. If something is not visible or told, it is difficult to plan treatment. Conversion disorder may slip through the cracks when determining possible presence of disorder. Conversion disorder with conceptual and treatment challenges. Full text electroconvulsive therapy treatment in patients. Functional neurologic disorders or conversion disorder include nervous system symptoms affecting movement or the senses that are not caused by medical disease. Doctors from many specialties can be involved in treatment. Aug 18, 2017 for some people, the symptoms of conversion disorder may improve with time, even without treatment.
It also discusses what might cause them and options for treatment. Conversion disorder is as serious, impairing, and disabling as any medical disorder epilepsy, stroke and should be treated that way 22. While the exact cause of conversion disorder is unknown, researchers believe it occurs in response to stressful situations or trauma. An example of this is a person who loses his voice following a situation in which he was afraid to speak. For example, speech therapy may benefit the individual if their symptoms include trouble with speaking or swallowing. The terminology, diagnosis, epidemiology, prognosis, clinical features, and assessment are discussed separately, as are specific subtypes of conversion disorder psychogenic nonepileptic seizures and functional movement disorders. The disorder is common in clinical settings and often has a poor prognosis.
This is a treatable issue with symptoms that will get better over time stress needs to be expressed by the body, either by words or symptoms conversion disorder is a bodys way of blowing off steam, sending false alarms to the nervous system. Functional magnetic resonance imaging has shown cerebral correlates of clinical signs. Conversion disorder functional neurological symptom disorder is characterized by neurologic symptoms eg, weakness, abnormal. Treatment may include psychotherapy, hypnosis, and stress management training to help reduce symptoms. The course of a conversion disorder can vary across different individuals. Occupational therapy should be part of conversion disorder. Since the symptoms of each patient with conversion disorder are different, treatments must be tailored to each individual patient. Aug 07, 2017 however, it is not uncommon for patients with neurological diseases to also have conversion disorder. Neurologists, psychiatrists, and other professionals should communicate regularly to make sure that they are on the same page about the cause and treatment of various symptoms. The most important and difficult step in treating conversion disorder is making the correct diagnosis. In simple tracking studies, roughly 50% of patients had recovered at four and ten year followups. Pdf treatment of a severe conversion disorder in a 10year.
Cognitivebehavioral therapy looks promising as the psychological treatment of choice, although more definitive data are still awaited, while. Treatment of a severe conversion disorder in a 10yearold boy. A brief summarize of conversion disorder treatments. A clinical and holistic approach by tocchio august 2009, vol. Physical therapy management of an adolescent with conversion disorder. Conversion disorder symptoms tend to reflect an intolerable conflict in a way that is unique to the particular stressor or trauma. Your medical team provides treatment of any medical or neurological disease you may have that might be a trigger for your symptoms. Somatization and conversion disorder sage publications. Electroconvulsive therapy treatment in patients with somatic symptom and related disorders kawai leong,1 joseph cw tham,2 anton scamvougeras,2 fidel vilarodriguez3 1department of psychiatry, 2bc neuropsychiatry program, department of psychiatry, 3noninvasive neurostimulation therapies laboratory at ubc, department of psychiatry, university of british. Yet, following a thorough evaluation, which includes a detailed neurol. Functional neurological disorder conversion disorder is defined in the american psychiatric association.
Electroconvulsive therapy treatment in patients with. Case history and treatment of a conversion disorder tahira. Diagnosis of conversion disorder is based on identifying particular signs that are common among people with the disorder, as well as performing tests to rule out other causes of the symptoms. Reproduce for distribution to other students, faculty, or staff. Treatment is based on the described and physical symptoms. A clinical approach to paediatric conversion disorder continued nonepileptic seizures. It describes what dissociation is and what types of dissociative disorders there are. Conversion disorder in adults management and treatment. For this reason, the dissociative disorders were historically grouped with the conversion disorders under the broad rubric of. Treatment success can be enhanced by discussing the possibility of a somatoform disorder with the patient early in the evaluation process, limiting unnecessary diagnostic and medical treatments. How the world treats conversion disorder winston churchill. This can occur after they receive a diagnosis of the disorder, reassurance that the symptoms arent caused by an underlying problem, and validation that the symptoms are real.
Effective treatment for conversion disorder treats both the condition and any cooccurring disorders the person is experiencing. Rather, it means that the dissociative disorders are not instigated by some palpable insult, injury, or disease affecting the brain. When conversion symptoms occur in isolation, the primary diagnosis is conversion disorder. Conversion disorder functional neurological symptom disorder is characterized by neurologic symptoms eg, weakness, abnormal movements, or nonepileptic seizures that are inconsistent with a neurologic disease, but cause distress andor impairment 1. Pdf conversion disorder cd in children remains a major challenge both in pediatric and mental health clinics and is still a prevalent psychiatric. The focus of psychotherapy is to help the individual understand the emotional. In factitious illness the purpose is to be a patient and under medical care. In both dsmiv and icd10 classifications, nonorganic neurological symptoms must occur in isolation for a diagnosis of conversion disorder to be made. Behavioral management of conversion disorder archives of.
Understanding dissociative disorders this booklet is for anyone who has, or thinks they may have, a dissociative disorder, and their family and friends. Diagnostic and statistical manual of mental disorders, fifth edition american psychiatric association. Nov 09, 2015 conversion disorder, as stated in the diagnostic and statistical manual of mental disorders, fourth edition, text revision dsmivtr, involves symptoms or deficits affecting voluntary motor or sensory function that suggest a neurologic or other general medical condition. Throughout its history, the etiology, diagnosis, and treatment of this disorder have been a. Cognitive behaviour therapy to treat a case of conversion. By determining origin of symptoms, a physical therapist can properly administer treatment. Randomized controlled clinical trials found that conversion disorder can be successfully treated with cbt which included the modification of catastrophic.
The focus of psychotherapy is to help the individual understand the. Treatment for patients with a functional neurological disorder conversion disorder. What families should know about conversion disorder. Although there is general agreement that treatment should address. Conversion disorder is a neurological disorder in which physical symptoms are unconsciously caused by a stressful or traumatic event. Functional neurologic disordersconversion disorder. Lower levels of hypochondriacal beliefs and behaviors lower levels of illness anxiety. Case history and treatment of a conversio n disorder tahira yousaf institute of professional psychology bahria university, karachi campus abstract the aim of the present study is to describe the case study and treatment of severe functional impairment in a nineteen year old young female adolescent with conversion disorder.
For example, poor awareness or concern about symptoms can also occur in people with neurological disorders. For example, the patient may complain of blindness, yet cortical visual evoked potentials are normal. Jul 03, 2017 the symptoms of conversion disorder dont typically last for more than a few weeks. Conversion disorder, also called functional neurological symptom disorder, 1 is defined as a psychiatric illness in which symptoms and signs affecting voluntary motor or sensory function cannot be explained by a neurological or general medical condition. Jan 11, 2018 while the exact cause of conversion disorder is unknown, researchers believe it occurs in response to stressful situations or trauma. Place in the sage colleges library collection and reproduce for interlibrary loan. The disorder is common in clinical settings and often has a poor prognosis 25. Menstrual disorders reproductive age in the reproductive age, psychologic causes of menstrual disorers involve marital and sex life, a detailed history might reveal significant events that precedes anovulatory episodes. Nowadays, there are different approaches for disorder treatment, depending on the theoretical model used for the intervention. Conversion disorder functional neurologic symptom disorder is characterized by neurologic symptoms eg, weakness, abnormal movements, or nonepileptic seizures that are inconsistent with a neurologic disease, but cause distress, andor impairment.
The existence of conversion disorder has been known and documented for millennia. Onset tends to be more gradual than occurs with epileptic seizures. We describe a patient with nonepileptic seizures and psychogenic tremors as a starting point for a discussion about how to. Diagnostic and statistical manual of mental disorders dsmv as a condition in which symptoms and deficits in altered voluntary motor and sensory function. Conversion disorder one or more symptoms of altered voluntary motor or sensory function. Conversion and somatic symptom disorders are psychiatric conditions that fall under the somatic symptoms and related disorders category of the dsm5.