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Conversion Disorder

DSM IV Criteria

The patient complains of symptoms or deficits affecting voluntary muscles, or deficits of sensory function that suggest a neurological or medical condition.

The temporal relation of symptoms to a stressful event suggests association of psychological factors.

Symptoms are not intentionally produced.

Symptoms are not explained by an organic etiology.

Symptoms result in significant functional impairment.

Symptoms are not limited to pain or sexual dysfunction, and are not explained.

Symptoms most commonly are sensory (blindness, numbness) and motor deficits (paralysis, mutism).

Abnormalities usually do not have an anatomical distribution and the neurological exam is normal.

Patients often lack the characteristic normal concern about the deficit. This characteristic lack of concern has been termed Ala belle indifference.@

Conversion disorder can coexist with depression, anxiety disorders, and schizophrenia.

Conversion symptoms often will temporarily remit after the disorder has been suggested.

Conversion disorder occurs in 1-30/10,000 in the general population and in up to 3% of outpatient psychiatric patients.

The disorder is more common in lower socioeconomic groups.

Medical conditions must be excluded.

Somatization Disorder begins in early life and involves multi-organ symptoms. Patients tend to be very concerned about symptoms.

Factitious Disorder. Symptoms are under conscious voluntary control, and they are intentionally put forth to assume a sick role. In conversion disorder, symptoms are not consciously produced.

Malingering is characterized by the presence of external motivations behind fabrication of symptoms.

Treatment of Conversion Disorder

Symptoms typically last for days to weeks and