Cerebral disease and hysteria

Abstract

An association between hysteria and cerebral disease is well recognized. 1–4 Slater 5 reported that at follow-up of 85 patients originally diagnosed as hysteria, in only “approximately 40% … no evidence for organic disease has yet been found.” Slater and Roth 6 considered that this association “may occur in either of two ways. Organic damage to the brain … may create or greatly increase a natural disposition to hysterical manifestations,” or secondly “… by providing a focus for the development of a constellation of ideas.” Recently, Merskey and Buhrich 7 reported that 48% of 89 patients with conversion symptoms had cerebral disorder or systemic illness affecting the brain. They too concluded that this indicated “a relationship between organic cerebral disease and hysterical conversion symptoms.” They also considered that this was due to both an organic factor as well as to psychological factors. The difficulty in attempting to separate and evaluate the relative contribution of organic and psychological factors is that cerebral disease often causes symptoms with which both can be identified. Thus, both factors may be present in the same patient with an hysterical neurosis. To examine this question it was decided to study patients with hysterical convulsions. The hypothesis tested here was that there is an association between hysteria and brain disease and that it is due mainly to psychological factors.