Conversion disorder, also called functional neurological symptom disorder, and previously known as hysteria
Sigmund Freud first used the phrase conversion disorder
Examples of conversion symptoms include:
Patients diagnosed with conversion disorder are not feigning the signs and symptoms. Despite the lack of a definitive organic diagnosis, the patient’s distress is very real and the physical symptoms the patient is experiencing cannot be controlled at will (i.e., the patient is not malingering an illness)
Unfortunately DSM-V and ICD-10 use the terms conversion and dissociation differently.
In DSM-5, the diagnostic criteria for conversion disorder (now also named functional neurologic symptom disorder) have abandoned a requirement for recent psychological stress in recognition that this is not identifiable in many patients. Instead, there is a criterion demanding evidence of the positive clinical examination features that neurologists use to make these (and other) diagnoses.
The ICD-10 classifies conversion disorder as dissociative (conversion) disorder, which suggests the symptoms arise through the process of dissociation.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), conversion disorder is characterized by the following:
According to psychodynamic theory, conversion symptoms develop to defend against unacceptable impulses
According to learning theory, conversion disorder symptoms are a learned maladaptive response to stress. Patients achieve secondary gain by avoiding activities that are particularly offensive to them, thereby gaining support from family and friends, which otherwise may not be offered.
Last reviewed 01/2018