What is conversion disorder?

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In this blog we will discuss what conversion disorder is. 

We will also discuss how prevalent it is, the diagnostic criteria, symptoms, and the possible causes and treatments available for this disorder. 

What is conversion disorder?

Conversion disorder also known as Functional neurological symptom disorder is a psychological disorder recognised by the Diagnostic and Statistical manual for mental disorders.

This disorder is marked by temporary physical symptoms that appear to be neurological with no obvious and physical cause. An individual with this disorder might exhibit symptoms such as blindness, paralysis, as well as tremors. 

Experts believe that this particular disorder is a result of an individual psychological response to mental, physical, and psychological trauma or a response to stressful situations. 

This particular disorder is also observed when there are some changes in the brain on a structural, cellular, or metabolic level and can occur when there does not seem to be a clear cause or trigger.

How prevalent is Conversion disorder?

Conversion disorder is relatively rare as opposed to other disorders and the rates of the relevance depends on what population is considered.

Researchers have found that there is an incidence of 4-12 cases per 100,000 individuals every year across geographical settings. 

 In the case of outpatient populations, research finds the prevalence rates to be somewhere between 4-6% who had conversion disorder; however, these estimates are based on old research.

Studies also concluded that more women are diagnosed as compared to men and for children, it is rare for children under 5 years and more common in teens. It is also observed that there seems to be no racial or cultural differences in prevalence however, more research needs to be done for more conclusive data. 

What are the diagnostic criteria for conversion disorder?

The Diagnostic and Statistical Manual of Mental Disorders, 5 edition (DSM-5) considers Conversion disorder as part of the “Somatic symptom and related disorders.” 

The diagnostic criteria for conversion disorder, according to the DSM-5, are as follows:

  • One or more symptoms of altered voluntary motor or sensory function.
  • Clinical findings can provide evidence of incompatibility between the symptom and recognized neurological or medical conditions.
  • Another medical or mental disorder does not better explain the symptom or deficit.
  • The symptom or deficit results in clinically significant distress or impairment in social, occupational, or other vital areas of functioning or warrants medical evaluation. (American Psychological Association)

What are the symptoms of conversion disorder?

Some of the symptoms of conversion disorder include:

  • weakness
  • paralysis of the arms or legs
  • vertigo
  • Seizures
  • episodes of unresponsiveness
  • difficulty swallowing
  • a feeling of a lump in the throat
  • shakes and tremors
  • difficulty walking
  • slurred speech or loss of speaking ability
  • difficulty hearing or loss of hearing
  • double vision, blurred vision, or episodes of blindness
  • numbness or loss of the touch sensation (Medicalnewstoday)

These symptoms can be mild or severe to the point it affects an individual’s daily life. The symptoms also may stop and start or be continuous, and usually affect the bodily functioning of the individual. 

What are the causes of conversion disorder?

The causal factor of this particular disorder is not clearly known however it is assumed that there are psychological, social, and biological factors that can all contribute to the development and maintenance of this particular disorder. 

The most obvious facial factor is an individual response to trauma, life stressors- acute or chronic, and an adverse life event that the individual might have experienced. 

When it comes to traumatic and adverse life conditions these include:

  • A history of childhood abuse- emotional, phsycial, and sexual abuse. 
  • Poor resilience and ability to manage and cope with psychological distress.
  • Other psychiatric disorders (depression, anxiety, and personality disorders) 
  • Multiple physical complaints, like generalised fatigue, weakness, or general ill health without a definite cause.
  • It is also possible that a physical injury or a stroke or migraine can lead to the symptoms of this disorder.
  • Poverty and poor socioeconomic status. 

One school of researchers believe that conversion disorder is a result of emotional conflict related to negative life events and trauma etc which are repressed into the unconscious mind which develops into a simpson. 

This particular cohort of theorists believe that the manifestation symptoms of this disorder is a defence mechanism against the conflict and is a result of inadequate coping and lack of healthy relationships during developmental years.

Another model for this particular disorder is the Cognitive-behavioural models. 

According to this model, the researchers and theorists hypothesis that the disorder is caused by an individual’s exposure to information related to a symptoms can lead to the recreation of these atoms in the memory and when the individual is distressed by trauma or negative events, the recreated symptoms is activated and overrides the sensory input and becomes a symptom that is manifested.

For example, a person watches someone else having a seizure and this creates a memory in their mind. Later when they encounter a stressful situation, they begin to feel anxious, distressed and begin to worry and this worry and anxiety when it crosses a certain threshold, activates the memory leading them to actually experience something like a seizure. 

What are the treatments available for conversion disorder?

The various treatment for this particular disorder include:

Psychotherapy

Psychotherapy has been found to help people with conversion disorder recognize triggers and symptoms and learn new ways to cope with them. These therapies include:

Cognitive behavioural therapy

In terms of Cognitive behavioural therapies your therapist will teach you how to regulate your negative and irrational thoughts when you come across triggers. 

As you engage in therapy you will start learning to alter your thoughts, develop an awareness of how you feel, and as a consequence the way you react in situations where you are faced with a real or imagined trigger. 

Rational Emotive Behavioural therapy

REBT is an action-oriented type of CBT that addresses unhealthy or irrational beliefs and attitudes that influence thoughts,  emotions, and behaviours. 

It follows the ABC model of developing an awareness about the processes that influenced the development of the phobia such as the activating event, the beliefs that were developed as a result and the consequences of those beliefs. 

It uses a method known as “disputing” to assist individuals develop realistic and healthy beliefs and as a consequence develop the ability to rationalise their thoughts and their emotional and behavioural responses as well. 

Mindfulness-Based Stress Reduction (MBSR) for Scelerophobia

MBSR is an evidence-based program that involves mindfulness training to help people who are suffering from anxiety and other mental health issues. 

MBSR could be helpful in helping individuals deal with their triggers as it has been found to be effective in tackling anxiety issues in most cases. 

The program involves teaching and training individuals to develop skills to cope with the anxiety or to reduce the intensity of the anxiety. 

Pharmacological treatment

If your anxiety is extremely severe your doctor may prescribe you antidepressants or an anti-anxiety medication to assist and treat any comorbid depression and anxiety. 

Physical Therapy

Physical therapy is often used in cases of conversation disorders related to movement disturbance such as vertigo, coordination, balance, or walking or weak limbs. This form of treatment is done together with other treatments. 

Make positive lifestyle changes

Avoid drinking and doing drugs, instead eat a healthy diet that is full of nutrients and engage in exercise- this can be walks, joining the gym, or running a marathon. 

Make changes that benefit your physical health as well as allow you to engage with a positive crowd. If you think socialisation is not something you want to do, then there are plenty of exercises that you can do alone. 

Make sure you get good sleep by developing a healthy sleep hygiene as well. 

Conclusion

In this blog we will discuss what conversion disorder is. 

We will also discuss how prevalent it is, the diagnostic criteria, symptoms, and the possible causes and treatments available for this disorder. 

What are the symptoms of conversion disorder?

Some of the symptoms of conversion disorder include:

  • weakness
  • paralysis of the arms or legs
  • vertigo
  • Seizures
  • episodes of unresponsiveness
  • difficulty swallowing
  • a feeling of a lump in the throat
  • shakes and tremors
  • difficulty walking
  • slurred speech or loss of speaking ability
  • difficulty hearing or loss of hearing
  • double vision, blurred vision, or episodes of blindness
  • numbness or loss of the touch sensation (Medicalnewstoday)

These symptoms can be mild or severe to the point it affects an individual’s daily life. The symptoms also may stop and start or be continuous, and usually affect the bodily functioning of the individual. 

What’s an example of conversion disorder?

Common examples of conversion symptoms include:

  • Loss of vision and Blindness
  • Paralysis
  • Dystonia
  • Psychogenic nonepileptic seizures (PNES)
  • Aphonia
  • Amnesia
  • Unresponsiveness
  • Swallowing difficulties
  • Motor tic
  • Mobility issues and difficulty walking

What is the cause of conversion disorder?

The most obvious facial factor is an individual response to trauma, life stressors- acute or chronic, and an adverse life event that the individual might have experienced. 

When it comes to traumatic and adverse life conditions these include:

  • A history of childhood abuse- emotional, phsycial, and sexual abuse. 
  • Poor resilience and ability to manage and cope with psychological distress.
  • Other psychiatric disorders (depression, anxiety, and personality disorders) 
  • Multiple physical complaints, like generalised fatigue, weakness, or general ill health without a definite cause.
  • It is also possible that a physical injury or a stroke or migraine can lead to the symptoms of this disorder.
  • Poverty and poor socioeconomic status. 

Is conversion disorder an anxiety disorder?

No, conversion disorder is not an anxiety disorder however it is highly comorbid with mood disorder, panic disorder, generalised anxiety disorder, post-traumatic stress disorder which might lead people to think that this is a symptom of anxiety. 

What’s the difference between somatic symptom disorder and conversion disorder?

Somatic symptom disorder refers to a mental disorder where the individual experiences anxieties and fear related to them being afflicted with a disease or a disorder and they do not experience symptoms. 

Conversion disorder also known as Functional neurological symptom disorder is a psychological disorder recognised by the Diagnostic and Statistical manual for mental disorders.

This disorder is marked by temporary physical symptoms that appear to be neurological with no obvious and physical cause. An individual with this disorder might exhibit symptoms such as blindness, paralysis, as well as tremors. 

References

Peeling JL, Muzio MR. Conversion Disorder. [Updated 2021 May 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551567/

Fritscher.L.What Is Conversion Disorder (Functional Neurological Symptom Disorder)? Verywellmind. Retrieved on 9th February 2022. https://www.verywellmind.com/conversion-disorder-2671575#toc-treatment

Cadman.B. Conversion disorder: What you need to know. Medical News Today. Retrieved on 9th Feb 2022.https://www.medicalnewstoday.com/articles/320587

Wells.D. Conversion Disorder. Healthline. Retrieved on 9th Feb 2022. https://www.healthline.com/health/conversion-disorder

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