Conversion disorder in childhood--diagnosed too late, investigated too much?

Abstract

Conversion disorder is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)1 as a condition in which symptoms and deficits in voluntary motor function suggest a neurological or other physical condition which is in fact not present. Child psychiatrists have reported a prevalence of 1–3% in the patients they see.2,3 Among new outpatients at a paediatric neurology unit in the west of England the prevalence is closer to 10%. These cases place considerable demands on consulting time and diagnostic resources. In this paper a case is made for early recognition and for management by the general paediatric team.