Conversion disorder

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Conversion disorder

  1. 1. PRESENTED BY: Anam Khan
  2. 2.  Conversion disorder causes patients to suffer apparently neurological symptoms, such as numbness, blindness, paralysis, or fits, but without a neurological cause. It is thought that these problems arise in response to difficulties in the patient's life, and conversion is considered a psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV)  Formerly known as "hysteria",  The term "conversion" has its origins in Freud's doctrine that anxiety is "converted" into physical symptoms.
  3. 3.  Conversion Disorder involves sensory or motor symptoms ◦ Not related to known physiology of the body  E.g. glove anesthesia ◦ Conversion symptoms appear suddenly ◦ Conversion symptoms are related to marked stress. ◦ Mixed presentation . ◦ Popularized by Freud Ch 7.2
  4. 4. Presentation: Conversion disorder can present with motor or sensory symptoms including any of the following: Motor symptoms or deficits: 1. Impaired coordination or balance 2. Weakness/paralysis of a limb or the entire body (hysterical paralysis or motor conversion disorders) 3. Impairment or loss of speech (hysterical aphonia) 4. Difficulty swallowing or a sensation of a lump in the throat 5. Urinary retention 6. Psychogenic non-epileptic seizures or convulsions 7. Fixed dystonia unlike normal dystonia 8. Tremor, myoclonus or other movement disorders 9. Gait problems (Astasia-abasia) 10. Syncope (fainting)
  5. 5. Sensory symptoms or deficits:  Impaired vision (hysterical blindness)  Double vision  Impaired hearing (deafness)  Loss or disturbance of touch or pain sensation  Conversion symptoms typically do not conform to known anatomical pathways and physiological mechanisms, but instead follow the individual's conceptualization of a condition. Typically, the less medical knowledge a person has, the more implausible are the presenting symptoms. Persons with more sophisticated medical knowledge tend to have more subtle symptoms and deficits that may closely simulate neurological or other general medical conditions
  6. 6.  Acute cases ◦ Reassurance/appropriate rehabilitation ◦ Psychotherapy  Conversion disorder clients seek help from physicians and resent referrals to psychotherapists ◦ Psychoanalytic therapy is not effective for conversion disorder ◦ The cognitive-behavioral approach involves pointing out selective attention to physical sensations and discouraging the client from seeking medical assistance
  7. 7.  There is little evidence-based treatment of conversion disorder  Treatment may include the following: 1. Physiotherapy where appropriate 2. Occupational Therapy to maintain autonomy in activities of daily living 3. Treatment of comorbid depression or anxiety if present. 4. Other treatments such as cognitive behavioral therapy, hypnosis, EMDR, and psychodynamic psychotherapy, EEG brain biofeedback need further trials.

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