Conversion Disorder


Conversion Disorder

Description, Causes and Risk Factors:

A mental disorder in which an unconscious emotional conflict is expressed as an alteration or loss of physical functioning, usually controlled by the voluntary nervous system.

Conversion Disorder

A conversion disorder is a relatively uncommon mental disorder in which a person has physical symptoms that no medical condition, physical examination or testing can explain. The person is not "faking." The symptoms do not appear to be under the person's conscious control and they can cause significant distress. Examples of symptoms are a loss of muscle control, blindness, deafness, seizures or even apparent unconsciousness.

Episodes of conversion disorder are nearly always triggered by a stressful event, an emotional conflict or another mental health disorder, such as depression.

The exact cause of conversion disorder is unknown, but the part of the brain that controls your muscles and senses may be involved. It may be the brain's way of coping with something that seems like a threat.

Conversion disorder risk factors include:

    Recent significant stress or emotional trauma.

  • Being female — women are much more likely to get conversion disorder.

  • Being an adolescent or young adult — conversion disorder can occur at any age, but it's most common during adolescence or early adulthood.

  • Having a mental health condition, such as mood and anxiety disorders, dissociative disorder and certain personality disorders.

  • Having a family member with conversion disorder.

  • A history of physical or sexual abuse.

  • Financial problems.

The lifetime prevalence of conversion disorder is not known with certainty, and estimates range from 0.01% to 0.5% of the general population; it is more common in females, with female to male ratios ranging from 2:1 up to 10:1.

Symptoms:

Conversion disorder is characterized by one or more symptoms that suggest a neurological condition. Examples include:

    Poor coordination or balance.

  • Paralysis or weakness.

  • Difficulty speaking or swallowing.

  • Retention of urine.

  • Loss of touch or pain sense.

  • Blindness or other visual symptoms.

  • Deafness.

  • Seizures or convulsions.

Psychological factors, such as stress or conflict, are associated with the appearance of the physical symptoms.

Diagnosis:

Conversion disorder is diagnosed only after a thorough medical examination fails to find a physical explanation for the symptoms. Some diseases take years for diagnosis so conversion disorder should be considered a tentative, working diagnosis. Even when a known disease is present, conversion disorder can still exist if the symptoms cannot be explained by the medical illness. Up to two-thirds of those with conversion disorder also have a neurological condition.

Tests may include:

    Laboratory testing to rule out hypoglycemia or hyperglycemia, kidney failure, or drug-related causes.

  • Imaging studies, such as chest x-rays or CT scans.

  • Electrocardiogram (ECG, EKG) — a test that records heart activity by measuring electrical currents through the heart muscle.

  • Spinal fluid examination to check for neurological causes.

Treatment:

There is no single best treatment for a conversion disorder. A physician is likely to be supportive and reassuring and will adjust treatment goals to the specific situation. Most physicians will explain the limits of what physical examination and testing was able to show about the symptoms. They try to avoid confronting the individual with the idea that the symptoms are "false," because the symptoms are usually distressing and not within the person's control. It is helpful to avoid overly intrusive, uncomfortable medical testing, while continuing to monitor the symptoms.

Symptoms sometimes go away on their own after stress has been reduced, conflict has been resolved or the family or community has responded with a show of concern and support.

If symptoms do not improve relatively quickly, more vigorous rehabilitation may be required. Physical or occupational therapy can be helpful.

Psychotherapy can provide relief although there is no evidence that one type of therapy is more effective than another. Many therapists will focus on encouragement and motivational interviewing, with the aim of improving functioning. If the source of conflict or stress can be determined, it may be helpful to gain insight into what triggered the symptoms. For example, the person may be in conflict about leaving home, starting a new job or having a first child. In psychotherapy, the person may either learn to deal with the conflict or retreat from the source of distress. In either case, the physical symptoms may stop. Functioning remains a higher priority than insight.

As with psychotherapy, there is no single medication that is best for this disorder. Medication may be helpful to treat an underlying problem with anxiety or depression.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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