Definition

Conversion disorder is a neurological/psychiatric disorder. It is one of a group of psychological disorders called somatoform disorders.

Conversion disorder can be difficult to diagnose, but it is treatable.

Causes

The direct cause of conversion disorder is usually experiencing a very stressful or traumatic event. The disorder can be considered the way someone copes, or as a psychological expression of the event. An example of this is a person who loses his voice following a situation in which he was afraid to speak.

Risk Factors

Conversion disorder is more common in women and adolescents. Other factors that may increase the chance of conversion disorder include:

• A previous history of personality or psychological disease
• Physical or sexual abuse, particularly in children
• Economic difficulties
• Low socioeconomic status
• Family members with either conversion disorder or chronic illness
• Co-existing psychiatric conditions such as depression or anxiety
• Co-existing personality disorders, such as histrionic, passive-dependent, or passive-aggressive personality disorder

Symptoms

It is important to understand that the symptoms of conversion disorder are involuntary. The person affected is not consciously acting out or pretending. Symptoms of conversion disorder are real, but lack a connection to any known organic medical diagnoses. Conversion disorder may cause:

• Impaired coordination and balance
• Paralysis of an arm or leg
• Loss of sensation in a part of the body
• Loss of a sense, such as blindness or deafness
• Inability to speak
• Difficulty swallowing or a sensation of a lump in the throat
• Sensory symptoms, such as;
  • Loss of sense of pain
  • Tingling or crawling sensations
• Seizures

To be diagnosed with conversion disorder you must have at least one symptom, but you may also have many. The appearance of symptoms is linked to the stressful event and typically occur suddenly.

Diagnosis

Diagnosis of conversion disorder may be difficult. It is important for your doctor to carefully consider any physical causes for your symptoms. Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:

• Blood tests
• Electroencephalogram (EEG) to evaluate electrical activity in the brain
• Electrocardiogram (EKG) to evaluate electrical activity in the heart

Images of internal body structures may be taken with:

• X-rays
• CT scan
• MRI scan

If no physical cause is detected, the patient may either be referred to a neurologist or for a psychiatric consultation.

Treatment

Psychological disorders can carry a feeling of being stigmatized. It is important that you do not let this prevent you from seeking treatment.

In some cases, conversion disorder goes away on its own. Treatment consists of counseling and psychotherapy (especially cognitive behavioral therapy). It may also involve identifying and removing environmental triggers to decrease anything stimulating the conversion disorder.

If underlying anxiety or depression is also occuring, medications may be used to help treat those conditions.

It is important to be consistent with treatment to help prevent a recurrence of the disorder.

Prevention

Conversion disorder can’t be prevented because it occurs after a specific, traumatic event.

Psych—American Psychiatric Association http://www.psychiatry.org/mental-health

Canadian Psychological Association http://www.cpa.ca

Conversion disorder. The Merck Manual of Diagnosis and Therapy website. Available at:
http://www.merckmanuals.com/professional/psychiatric-disorders/somatic-symptom-and-related-disorders/conversion-disorder
Updated February 2012. Accessed July 22, 2013.