Conversion disorder: symptoms, treatments, and causes

Formerly known as hysteria, conversion disorder became famous in the late 19th century, with the majority of people diagnosed as women, who were thought to be repressed by the society that surrounded them.

On the other hand, the same Sigmund Freud proposed that this disorder had its origin a suppressed feeling of anger or unresolved internal conflicts, using hypnosis as the main remedy for this alteration.

At present, it has been investigated in much more depth, also known as dissociative disorder, a mental disorder in which the person unconsciously abandons control when integrating emotions or experiences and manifesting the discomfort through physical symptoms.

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What is conversion disorder?

Conversion disorder refers to a whole set of symptoms that interfere with human behavior and that apparently take the form of a neurological condition. However these symptoms do not correspond to any diagnosed physical alteration nor can they be justified by any other disease.

Currently, the main characteristic of this disorder is the appearance of symptoms or difficulties that interfere with the normal activity of the person, both at a motor and sensory level, these difficulties are not voluntary and are associated with psychological factors or alterations.

The term conversion is used to refer to the patient's ability to involuntarily transform a psychological disorder into a physical disorder or difficulty. These abilities can range from the simple difficulty or inability to operate some body parts to the use of the senses. For example, it has been documented that in some cases apparent blindness is experienced.

As mentioned above, people with this condition do not feign symptoms, but rather suffer from distress real, so it is not advisable to state in front of the patient that all his difficulties and ailments are within his head.

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Symptoms of conversion disorder

This type of complex disorder can present two types of symptoms, both motor and sensory:

Motor symptoms

• Coordination difficulties or balance
• Hoarseness or impairment of the ability to make sounds
• Urinary containment problems
• Paralysis or weakening of any body area, affecting the entire body
• Swallowing problems
• Fainting
• Dystonia
• Psychogenic crises or seizures

Sensory symptoms

• Vision deficits: ablepsia or double vision
• Hearing problems
• Loss in perception of touch

Causes and risk factors

Despite the fact that the causes of conversion disorder are not concisely established, it is theorized that the above symptoms are related to the appearance of some psychological conflict or some stressful event.

In general, the signs appear suddenly after the person experiences some traumatic experience or stressful. It has been observed that patients suffering from this disorder usually also have:

• Physical illnesses
• Dissociative disorders
• Personality disturbances

However, conversion disorder can also occur in apparently healthy people. there are a series of risk factors that make these subjects an easy target for this disorder.

• Excessive stress
• Emotional trauma
• Belonging to the female sex
• Relatives with conversion disorders
• Experiences of both physical and sexual abuse

Diagnosis

There are several steps to take to make a proper conversion disorder diagnosis. First of all, a distinction must be made as to whether the person actually suffers from a conversion disorder or, instead, is faking the symptoms.

Although it can be a difficult task, people with a tendency to fake symptoms often seek the obtaining some benefit from pretending, this motivation may be financial, emotional, need for attention, etc.

Then it has to exclude the possibility of the impact of a neurological disease, since this disease usually takes forms similar to that of a neurological disorder such as headache, epilepsy or sclerosis.

Therefore, it is vitally important that clinical staff rule out 100% any possibility of a underlying neurological disease, for this the neurology specialist must perform a thorough examination of the patient.

Likewise, it is necessary to eliminate the possibility that it is another type of disorder, such as a factitious disorder or the Munchausen syndrome for the powers. In the first, the person feigns the symptoms with the intention of avoiding obligations or being the center of attention; and in the second one, one of the parents or a caregiver, creates fictitious symptoms or causes some other real ones in the minor.

Finally, and in order to make a diagnosis as accurate as possible, it is necessary for the patient to present the following diagnostic criteria present in the Diagnostic and Statistical Manual of Mental Disorders (DSM):

• Presence of one or more difficulties that interfere with motor or sensory functions that suggest the presence of a neurological or medical disorder.
• Existence of previous events, experiences or conflicts that may be associated with the symptoms.
• The set of symptoms are not provoked consciously or voluntarily.
• Symptomatology not justified by the presence of another medical condition or disorder, nor by the consumption of substances.
• The symptomatology causes a clinically significant one, interfering in the different areas of the patient's daily life and requiring medical attention.
• With set of symptoms not restricted to pain or deficits in sexual function, does not appear during a somatization disorder and is not due to the onset of another sexual disorder.

Treatment and prognosis

The fundamental point in the treatment of conversion disorder is to suppress or reduce the source of stress, or otherwise work with traumatic events that the patient has experienced, in order to reduce the level of tension in it.

On the other hand, it is necessary to eliminate the secondary gains or benefits that the patient may be obtaining from this behavior, even if they are not fully aware of it.

Habitually, symptoms can be automatically remitted, lasting from days to weeks and coming to remit automatically. However, there are a number of resources and interventions which can benefit the patient. These are:

• Explanation of the disease
• Psychotherapy
• Occupational therapy
• Treatment of other present disorders such as depression or anxiety