Previously called hysterical neurosis, conversion type, a conversion disorder allows a patient to resolve a psychological conflict through the loss of a specific physical function, for example, by paralysis, blindness, or the inability to swallow. Unlike factitious disorders or malingering, the patient's loss of physical function is involuntary. However, laboratory tests and diagnostic procedures don't disclose an organic cause.

Conversion disorder can occur in either sex at any age. An uncommon disorder, it usually begins in adolescence or early adulthood. The conversion symptom itself isn't life-threatening and usually has a short duration.

Causes

The patient suddenly develops the conversion symptom soon after experiencing a traumatic conflict that he believes he can't handle. Two theories explain why this occurs. According to the first, the patient achieves a "primary gap," when the symptom keeps a psychological conflict out of conscious awareness. For example, a person may experience blindness after witnessing a violent crime.

The second theory suggests that the patient achieves secondary gain from the symptom by avoiding a traumatic activity. For example, a soldier may develop a "paralyzed" hand that prevents him from entering into combat.

Signs and symptoms

Common signs of a conversion disorder include:

Sudden onset of physical symptoms
Recent history of a stressful experience
Inappropriate lack of concern over the physical symptoms

The symptoms of conversion disorder involve the loss of one or more bodily functions. These may include blindness, paralysis or the inability to speak. The loss of physical function is involuntary and diagnostic testing does not show a physical cause for the dysfunction.

Treatment

Psychotherapy, family therapy, relaxation therapy, behavior therapy, or hypnosis may be used alone or in combination (two or more) to treat conversion disorder.

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