Conversion disorder is characterized by neurological symptoms that cannot be explained by medical causes. Instead, psychological stressors are associated with the onset of symptoms. Patients are unaware of the psychological basis and cannot consciously control their symptoms. Common symptoms include paralysis, abnormal movements, seizures, and sensory disturbances. Diagnosis involves ruling out physical disorders and assessing for dissociation. Treatment options include psychotherapy, hypnosis, and supportive therapy.

1. Conversion Disorder

2. CONVERSION DISORDER
 Conversion disorder is characterized by the presence of
one or more symptoms suggesting the presence of a
neurological disorder that cannot be explained by any
known neurological or medical disorder. Instead ,
psychological factors like, stress and conflict are
associated with onset.
 Patients are unaware of the psychological basis and are
this not able to control their symptoms.

3. Common signs and symptoms of
conversion disorder
 The symptoms of produced because they reduced the
anxiety of the patients by keeping the psychological
conflict out of conscious awareness, a process called as
primary gain
 These symptoms of conversion are often advantages to
the patients
Example :- a woman who develops psychogenic paralysis of
the arm may escape from taking care of an elderly relatives
,such an advantage is called as secondary gain.

4.  The patient doesnot produce the symptoms intentionally.
 The patient shows less distress or shows lack of concern
about the symptoms, called as Labelle indifference.
 Physical examination and investigations donot reveal any
medical or neurological abnormalities.
 Lack of conscious control over the symptoms
 Impaired functioning in social work related areas caused
by symptoms.

5.  In ICD 10, CONVERSION DISORDER IS SUBSUMED UNDER
,DISSOCIATIVE DISORDER OF MOVEMENT AND SENSATION,A
SUBTYPE UNDER DISSOCIATE (CONVERSION ) DISORDER.
 IT IS FURTHER CLASSIFIED INTO DISSOCIATIVE MOTOR
DISORDER, DISSOCIATIVE ANESTHESIA AND SENSORY LOSS
AND DISSOCIATIVE CONVULSIONS.

6.  Conversion disorders were formerly called as hysteria, the
term is now changed because the word hysteria is used in
everyday speech when referring to any extravagant
behaviour,.

7. Dissociative motor disorder
 It is characterized by motor disturbances like paralysis or
abnormal movements. Paralysis may be a monoplegia,
paraplegia or quadriplegia. The abnormal movement may
be tremors,choreiform movements or gait disturbances
which increase when attention is directed towards them,
examination reveals normal tone and reflexes.

8. Dissociative convulsions (hysterical fits
or pseudo-seizures)
 It is characterized by convulsive movements and partial
loss of consciousness,

9. Dissociative sensory loss and anaesthesia
 It is characterized by sensory disturbances like
hemianesthesia, blindness, deafness and glove
and stocking anesthesia (absence of sensations at
wrists and ankles)
 The disturbance is usually based on patients
knowledge of that particular illness whose
symptoms are produced.

10. Dissociative disorder
 Dissociation is the mechanism that allows our mind to
separate certain memories from conscious awareness. The
dissociative disorder are described as a disturbance in the
ordinarily organized functions of the conscious
awareness,memory and identity.

11. Common clinical types
 Dissociative amnesia
 Dissociative fugue
 Dissociative identity disorder
 Trauce and possession disorder
 Other dissociative disorder

12. Dissociative amnesia
 Most often, dissociative amnesia follows a traumatic or
stressful life situation. There is a sudden inability to recall
important personal information particularly concerning
the stressful life event.the extent of the disturbance is
too great to be explained by ordinary forgetfulness.

13. Dissociative fugue
 Psychogenic fugue is a sudden,unexpected travel
away from home or workplace,with the
assumption of a new identity and an inability to
recall the past. The onset is sudden , often in the
presence of severe stress.following recovery there
is no recollection of the events that took place
during the fugue.

14. Dissociative identity disorder
 In this disorder,the person is dominated by two or
more personalities of which only one is manifest
at a time. The condition typically involves the
coexistence of two or more personality states
with in the same person.while the different
personality states influence the persons
behaviour,the person is usually not aware of these
personality states and experiences them as
memory loss.

15. Other dissociative disorder
 Gansers syndrome ,the characteristic feature is
vorbeireden –giving approximate answers to questions.
The term approximate answers denotes answers to simple
questions that are plainly wrong.
For example :- when asked to add three and three a patient
might answer seven, when asked four or five might answer
ten, each answer is one greater than the correct answer,
hallucinations are usually visual and may be elaborate.

16. Etiology of conversion and dissociative
disorder
 Psychodynamic theory
 Behavior theory

17. Diagnosis
 Rule out physical disorder and substance abuse
 Standard tests including the dissociative experiences scale
and dissociative disorders interview schedule to
demonstrate presence of dissociation.
 ICD 10 CRITERIA

18. TREATMENT
 FREE ASSOCIATION
 HYPNOSIS
 ABREACTION THERAPY
 SUPPORTIVE PSYCHOTHERAPY
 BEHAVIOR THERAPY
 DRUG THERAPY

19. other neurotic disorder
 According to ICD 10 , The other neurotic disorder are
neurasthenia, depersonalization- derealisation syndrome,
and culture bound syndromes.
NEURASTHENIA :- IS characterized by persisting and
distressing complaints of increased fatigue after mental or
physical effort.
DEPERSONALIZATION :- Is characterized by an alteration in
the perception or experience of self so that the feeling of
ones own reality is temporarily changed or lost
DE realization :- is an alteration in the perception or
experience of the external world,so that the feeling of
reality of external world is temporarily changed or lost.

20.  Dhat syndrome :- is a culture –bound syndrome, which is
prevalent in the indian suncontinent,characterized by
complaint of passage of whitish discharge (dhat) in
urine,multiple somatic symptoms,physical or mental
exhaustion,anxiety or depression, and sexual dysfunction.

21. Treatment
 Supportive psychotherapy
 Counselling
 antidepressants

22. Geriatric considerations
 Common anxiety disorders during late life are phobias
,agoraphobia, and GAD .
 ANXIETY that starts for the first time during late life is
frequently associated with depression,dementia,physical
illness or medication toxicity or withdrawal.
 Through less common, panic attacks can occur in late life
and are related to depression or a physical illness such as
cardiovascular, gastrointestinal
 The treatment of choice for anxiety disorders in the
elderly is selective serotonin reuptake inhibitor.