A Family Guide to Conversion Disorder

Todd Peters, MD

What is Conversion Disorder?

  • It is a type of “somatization disorder,” which is a mental disorder that presents as physical complaints/symptoms that affect multiple different body symptoms that are not knowingly motivated or faked, that affect the “voluntary central nervous system” (controls body movements)
  • Both children and adults (females>males) can be diagnosed with this disorder
  • Will be called “Functional Neurological Symptom Disorder” in the near future

DSM-IV-TR (2000) specifies six criteria for the diagnosis of conversion disorder. They are:

  • The patient has one or more symptoms or deficits affecting the senses or voluntary movement that suggest a neurological or general medical disorder.
  • The onset or worsening of the symptoms was preceded by conflicts or stressors in the patient's life.
  • The symptom is not faked or produced intentionally.
  • The symptom cannot be fully explained as the result of a general medical disorder, substance intake, or a behavior related to the patient's culture.
  • The symptom is severe enough to interfere with the patient's schooling, employment, or social relationships, or is serious enough to require a medical evaluation.
  • The symptom is not limited to pain or sexual dysfunction, does not occur only in the context of somatization disorder, and is not better accounted for by another mental disorder.

DSM-IV lists four subtypes of conversion disorder: conversion disorder with motor symptom or deficit; with sensory symptom or deficit; with seizures or convulsions; and with mixed presentation.

What is not Conversion Disorder?

  • malingering – purposefully motivated and faked to gain benefits for avoid consequences
  • factitious disorder – illness is faked, but the symptoms are driven by a need to be in the “sick role” that is not understood by those who are affected
  • epileptic seizures, strokes, tics,blindnessor other damage to the nervous system

What is the cause?

  • Distress is converted from emotional symptoms (sadness, anger, etc.) to physical symptoms that affect the nervous system
  • Depression and anxiety (both expressed and not expressed) can lead one’s body to convert emotional pain to physical pain
  • This conversion causes an chemical change in the body that causes loss of conscious control of that part of the body

How do you tell?

  • Diagnosis can only be made after a full medical work-up (as determined by your medical doctors) does not show damage to areas that would be affected
  • Observed signs and symptoms are often much worse than what would be expected by the disease/damage
  • Symptoms often become more severe when focusing on the illness

What families should know about Conversion Disorder:

  • This is a treatable issue with symptoms that will get better over time
  • Stress needs to be expressed by the body, either by words or symptoms – conversion disorder is a body’s way of “blowing off steam,” sending “false alarms” to the nervous system
  • Conversion disorder is as serious, impairing, and disabling as any medical disorder (epilepsy, stroke) and should be treated that way
  • Emotional issuesin conversion disorder can result in real chemical changes in the body that have been measurable in research studies
  • This diagnosis will only be made after a thorough medical and psychiatric assessment has been completed
  • Symptoms can change significantly over time into other areas of the body – new symptoms will be evaluated and assessed by the treatment team
  • Treatment consists of both individual and family therapy along with the potential for medication use to address underlying anxiety, depression, or trauma (if your physician feels it could help)
  • Symptoms/medical complaints are, unfortunately, expected to get worse at the start of treatment
  • This diagnosis and treatment can often cause “mixed emotions” in families that cause many different reactions, including the potential for anger, frustration, worry, sadness, and hopelessness at times
  • To avoid unnecessary tests and medical treatments, researchers have found that coordination and discussion between all doctors and therapists is essential - this is the way to provide the best care
  • Regular appointments with medical and mental health providers can be helpful – this should be discussed with your treatment team

Additional Resources for Families:

  • Rebecca J. Frey, Ph.D., “Conversion Disorder.”
  • American Academy of Child and Adolescent Psychiatry. 3615 Wisconsin Avenue, NW, Washington, DC 20016-3007 – phone: (202) 966-7300. Fax: (202) 966-2891. <
  • National Institute of Mental Health. 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663 – phone: (301) 443-4513. < .