Conversion disorder

  • Definition
    • Conversion disorder is a mental condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation.

  • Alternative Names
    • Functional neurological symptom disorder; Hysterical neurosis

  • Causes
    • Conversion disorder symptoms may occur because of a psychological conflict.

      Symptoms usually begin suddenly after a stressful experience. People are at risk of conversion disorder if they also have:

      • A medical illness
      • A dissociative disorder (escape from reality that is not on purpose)
      • A personality disorder (inability to manage feelings and behaviors that are expected in certain social situations)

      People who have conversion disorder are not making up their symptoms (malingering). Some doctors falsely believe that this disorder is not a real condition and may tell people that the problem is all in their head. But this condition is real. It causes distress and cannot be turned on and off at will.

      The physical symptoms are thought to be an attempt to resolve the conflict the person feels inside. For example, a woman who believes it is not acceptable to have violent feelings may suddenly feel numbness in her arms after becoming so angry that she wanted to hit someone. Instead of allowing herself to have violent thoughts about hitting someone, she experiences the physical symptom of numbness in her arms.

  • Symptoms
    • Symptoms of a conversion disorder include the loss of one or more bodily functions, such as:

      • Blindness
      • Inability to speak
      • Numbness
      • Paralysis

      Common signs of conversion disorder include:

      • A debilitating symptom that begins suddenly
      • History of a psychological problem that gets better after the symptom appears
      • Lack of concern that usually occurs with a severe symptom
  • Exams and Tests
    • Diagnostic testing does not find any physical cause for the symptoms.

      The doctor will do a physical exam and may order diagnostic tests. These are to make sure there are no physical causes for the symptom.

  • Treatment
    • Talk therapy and stress management training may help reduce symptoms.

      The affected body part or physical function may need physical or occupational therapy until the symptoms go away. For example, a paralyzed arm must be exercised to keep the muscles strong.

  • Outlook (Prognosis)
    • Symptoms usually last for days to weeks and may suddenly go away. Usually the symptom itself is not life threatening, but complications can be debilitating.

  • When to Contact a Medical Professional
    • See your health care provider or mental health professional if you or someone you know has symptoms of a conversion disorder.

  • References
    • American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013.

      Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 39.

      Cottencin O. Conversion disorders: Psychiatric and psychotherapeutic aspects. Neurophysiol Clin. 2014;44:405-10. PMID 25306080