Conversion Disorder

Full name:

Conversion Disorder (Functional Neurological Symptom Disorder)

Key feature:

Altered motor or sensory function that is inconsistent with neural/medical conditions and not better explained by another disorder

The key feature of conversion disorder is often suggestive of

neurological problem, but no such problem is detected

Must cause

significant distress/impairment

May display

indifferent attitude toward symptoms (“la belle indifference”)

Functioning may be

mostly normal

Not deliberately

faking symptoms for the purpose of concrete gains (malingering)

DSM-5: One or more symptoms of

altered motor or sensory function

DSM-5: Incompatibility between

symptom and medically recognized conditions

DSM-5: Not

better explained otherwise

DSM-5: Causes

significant stress

Rare condition,

with a chronic intermittent course

Often comorbid with

anxiety and mood disorders

Seen primarily in

females

Onset usually in

adolescence

Common in some

cultural and/or religious groups

Causes: Not well

understood

Causes: Freudian

psychodynamic view is still common, though unsubstantiated

Causes: Past trauma or unconscious conflict is

“converted” to a more acceptable manifestation, i.e., physical symptoms

Primary/secondary gains: Freud thought

primary gain was the escape from dealing with a conflict

Secondary gains:

Attention, sympathy, etc.

More common in

lower education, lower SES

Patients likely to adopt

symptoms with which they are already familiar

Treatment: If onset after a trauma,

may need to process trauma or treat posttraumatic symptoms

Treatment: Remove

sources of secondary gain

Treatment: Reduce

supportive consequences of talk about physical symptoms