Diagnosis of conversion disorders in a rehabilitation setting

Abstract

Conversion disorders are unexplained symptoms or deficits that mimic neurological problems and affect voluntary motor and sensory functions. Historically, conversion symptoms were thought to reflect underlying psychological conflicts although recent behavioural theories view them as learned responses to stressful life circumstances and emphasize environmental contingencies in the maintenance of the disorder. Although early studies often revealed underlying organic disease in patients initially diagnosed with Conversion Disorder, this now occurs less frequently because of increased sophistication of diagnostic tools and better understanding of neurological disorders. However, misdiagnosis is still common because of reliance on 'negative' diagnostic testing and unvalidated 'positive signs' misinterpreted as indicative of hysteria. Psychological factors may affect the course of almost every major category of disease and in many cases a diagnosis of hysteria is not indicated and the more appropriate diagnosis is Psychological Factors Affecting A Medical Condition. It is not possible to definitively differentiate between conscious and unconscious production of symptoms thus blurring the distinction between Conversion and Factitious disorders.