Conversion disorder is a condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation.
Causes, incidence, and risk factors
Conversion disorder symptoms may occur because of a psychological conflict.
Symptoms usually begin suddenly after a stressful experience. People are more at risk for a conversion disorder if they also have a medical illness, dissociative disorder, or a personality disorder.
It is important to understand that patients are not making up their symptoms (malingering). Some doctors falsely believe that conversion disorder is not a real condition, and may tell patients the problem is all in their head. However, these conditions are real. They cause 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 may experience the physical symptom of numbness in her arms.
Symptoms of a conversion disorder include the loss of one or more bodily functions, such as:
Inability to speak
Diagnostic testing does not find any physical cause for the symptoms.
Signs and tests
Common signs of conversion disorder include:
A debilitating symptom that begins suddenly
A history of a psychological problem that gets better after the symptom appears
A lack of concern that usually occurs with a severe symptom
Your doctor will do a physical examination, and possibly diagnostic tests, to rule out physical causes for the symptom.
Talk therapy (psychotherapy) and stress management training may help reduce symptoms.
The affected body part or physical function will need physical or occupational therapy until the symptoms disappear. For example, paralyzed limbs must be exercised to prevent muscle wasting.
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.
Calling your health care provider
Call for an appointment with your health care provider if you or someone you know has symptoms of a conversion disorder.
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: Mosby Elsevier; 2008:chap 39.
Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Michelle Benger Merrill, MD, Instructor in Clinical Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.