CONVERSION DISORDER

It is infrequently seen. However, patients with conversion disorder, which Freud called hysteria, made up a significant portion of Freud’s clientele, and observations about these patients were important in the development of psychoanalysis.

Symptoms

Conversion disorder can have many different presentations and symptoms. Motor symptoms include weakness or paralysis, abnormal movements such as tremor, and difficulty walking. Sometimes people experience sensory symptoms, such as altered, reduced, or absent skin sensation, vision, or hearing. Conversion disorder can also take the form of “psychogenic” or “non-epileptic” seizures, which include limb shaking and impaired or loss of consciousness but without the electrical activity that occurs in the brain during a seizure. Other common symptoms include episodes of unresponsiveness that resemble fainting or coma, reduced or absent speech volume, changes in articulation when speaking (slurred speech), a sensation of a lump in the throat, and double vision. People with conversion disorder are not faking their symptoms, and despite not having a clear physiological origin, the symptoms cause real distress and cannot be controlled at will. The severity of the disability caused by conversion disorder can be similar to that experienced by people with comparable medical diseases.

Causes

The onset of symptoms is usually sudden and can be associated with stress or a traumatic event. Stressful life events are often present in people who develop conversion symptoms, but this is not always the case. Conversion disorder can develop at any time throughout the lifespan. The onset of non-epileptic seizures is most common in the third decade of life, and motor symptoms have their peak onset in the fourth decade of life.