Conversion Disorder

Overview

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
- 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)
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

Not well understood
Freudian psychodynamic view is still common, though unsubstantiated
- 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.
Sociocultural factors
- More common in lower education, lower SES
- Patients likely to adopt symptoms with which they are already familiar

If onset after a trauma, may need to process trauma or treat posttraumatic symptoms
Remove sources of secondary gain
Reduce supportive consequences of talk about physical symptoms