Mental health nursing

1. Conversion
Disorder

2. Introduction
• A psychological condition that causes symptoms that
appear to be neurological, such as paralysis, speech
impairment, or tremors, but with no obvious or known
organic causes
• Previously known as Hysteria

3. Cont’d…
• Characterized by neurological symptoms which are not
explained by any known neurological or medical
condition
• Unaware so unable to control their symptoms
• Categorized as a type of somatic symptom disorder
according to DSM-5

5. Cont’d…
• Lifetime prevalence rates of conversion disorder are
between 11–300 per 100,000 people
• 5–14% of general hospital patients are diagnosed with
conversion disorder
• 1–3% of outpatient referrals to psychiatrists are
diagnosed with conversion disorder

6. Cont’d…
• 5–25% of psychiatric outpatients are diagnosed with
conversion disorder
• An estimated 20–25% of those in a hospital setting
meet some of the criteria for conversion disorder
diagnosis
• Conversion disorders are more common in adult
women than men, with at least twice the number of
women diagnosed with conversion disorder than men

7. Cont’d…
• Conversion disorders are more common in populations
of individuals that have less education and lower
socioeconomic status
• Compared to developed countries, third-world or
developing countries can have up to a 31% prevalence
rate

8. Signs and symptoms
• Symptoms usually appear after a situation that
produces stress all of sudden; symptoms might
disappear as it appeared
• Symptoms promotes secondary gain as a way to obtain
attention or support

9. Cont’d…
Motor symptoms or deficits
• Impaired coordination or
balance
• Weakness/ paralysis of a limb
or the entire body
• Difficulty swallowing or a
sensation of a lump in the
throat
•Impairment or loss
of speech
•Urinary retention
•Tremor
•Gait problems
•Fainting

10. Cont’d…
Sensory symptoms
• Impaired vision
• Double vision
• Impaired hearing
• Loss or disturbance of touch or pain sensation
• Numbness

11. Diagnostic Measures
• History taking
• Physical examination
• CT and MRI scans:
• EEG

12. DSM V Criteria for Diagnosis
A. There must be at least one symptom of sensory or
motor impairment.
B. Symptoms are not caused by a neurological
condition, physical disease, or substance use.
C. Symptoms are associated with significant distress.
D. Symptoms are not better explained by another
physical or psychological condition.

13. Management
Pharmacological management
• Anxiolytic drugs
• Anti-depressant drugs
Non-pharmacological management
• Psychotherapy
• Cognitive behavioral therapy
• Individual psychotherapy
• Group therapy
• Relaxation therapy
•Meditation
•ECT and TMS

14. Nursing Interventions
• Protect the patient from harm or injury during
dissociative episodes
• Demonstrate to the client the importance of
discussing stress situations and exploring associated
feeling
• Structure the environment to reduce stimulation,
such as loud noises, bright lights, or extraneous
movements

15. Cont’d…
• Praise the client for using effective coping strategies
• Engage the client in appropriated therapies
• Approach the client in a clam, direct, non-
authoritarian manner, using a soft tone of voice
• Assist the client to gain control of overwhelming
feelings through verbal interactions

16. Cont’d..
• Teach the client social skills, and encourage him or her
to practice these skills with staff members and other
client
• Provide feedback regarding social interactions
• Encourage to practice progressive muscle relaxation
therapy

17. Cont’d..
• Provide feedback regarding social interactions
• Encourage client to pursuer personal interests,
hobbies, and recreational activities
• Encourage the client to identify supportive people
outside the hospital and to develop these
relationships