Q What is conversion disorder?
A. Conversion disorder or Hysteria is a disorder whereby a person expresses emotional
turmoil by converting it into a bodily symptom. It is now called as PSYCHOLOGICAL FACTORS AFFECTING MEDICAL CONDITIONS. The term "hysteria" is no longer used.

Q. How does a patient with hysteria present?
A. Hysteria may present as affliction of organ of special senses i.e. as hysterical deafness, hysterical blindness. It may also affect the voluntary nervous system and patient may present with hyperventilation, convulsions, paraesthesias etc.

Q. A patient has come with inability to walk suddenly. How do I know whether the patient actually has a problem?
A. There are two ways to diagnose a conversion disorders: -

1. Positive diagnosis whereby a temporal relationship between psychological stress and onset of symptoms is established. Associated features established are those of elicitable gain. The patient has dramatic symptoms without associated physical signs.
2. Negative diagnosis – The patient has multiple symptoms where the disability is out of proportion to any elicitable disorder. Conversion disorder is diagnosed as absence of any physical cause.

Conversion disorders are more common in females. They are often seen in families with unstable relationships. Patients may also have common associated symptoms like :-

1. Multiple hospitalisations for symptoms without signs.
2. Willingness to go through painful investigations.
3. In females, it may be associated with menstrual problems.

During the history taking, you may get a vicarious feeling as if the patient is enjoying the symptoms.

Q. How does hysteria occur?
A. There are two types of hysteria :

1. Conversion disorders whereby the emotional turmoil is expressed unknowingly as a bodily symptom
2. Dissociative states

1. Fugue
2. Amnesia
3. Dual personality disorders – e.g Jekyll & Hyde personality

Last created on 22-10-2001
Last updated on 18-11-2006