Conversion disorder: definition, causes, symptoms, and treatment

Conversion disorder is a condition in which a person experiences neurological symptoms that cannot be attributed to any known neurological or medical condition. The symptoms of this disorder are genuine but are not intentionally produced, and they typically stem from psychological factors or stress.

The precise causes of conversion disorder are not fully understood. However, it is believed that conversion disorder arises from a complex interaction between psychological factors and stressful life experiences, including childhood abuse, internal psychological conflicts, existing psychiatric disorders, history of multiple somatic complaints, physical injury or neurologic illness, and low socioeconomic status.

The symptoms of conversion disorder typically involve neurological manifestations that affect motor or sensory functions, such as weakness or paralysis, abnormal movements, balance problems, vision problems (blindness), hearing problems, numbness and loss of sensation, paresthesia, difficulty or inability to speak, and difficulty swallowing.

The treatments for conversion disorder are psychotherapy, physical therapy, hypnosis, and pharmacotherapy. Cognitive-behavioral therapy helps individuals understand and manage stressors contributing to their symptoms, altering thought patterns and behaviors. Physical therapy assists in addressing specific symptoms related to motor function and movement symptoms. Hypnosis does not directly treat the physical symptoms of the disorder but rather helps in exploring and addressing the emotional or psychological stress linked to the symptoms. Medications may be used to manage accompanying conditions like anxiety or depression, but they are not the primary focus of treatment. 

What is conversion disorder?

Conversion disorder (CD) is a condition in which a person has physical and sensory impairments, such as paralysis, numbness, blindness, deafness, or seizures, without any underlying neurologic illness.

According to the National Institute of Neurological Disorders and Stroke’s 2023 publication, titled “Functional Neurologic Disorder”, Austrian neurologist and the founder of psychoanalysis Sigmund Freud categorized functional neurological disorder as a “conversion disorder” because he believed that this psychological ailment converted into a neurological disorder. 

This disorder is typically characterized by neurological symptoms like weakness, sensory loss, or blackouts, which do not align with established neurological disease patterns, and are often referred to as functional, non-organic, hysterical, psychogenic, or dissociative,  as outlined in the 2011 issue of the Journal of Neurology, Neurosurgery & Psychiatry, titled “Conversion disorder: a problematic diagnosis”.

Certain experts in the field highlighted the role of psychological mechanisms, such as dissociation and repression, in shaping physical symptoms of conversion disorder, leading to a shift from a neurological to a primarily psychiatric classification, with a transition in diagnostic terminology, ultimately embracing more neutral and agnostic models over the 20th century.

What is another name for conversion disorder?

Another name for conversion disorder is functional neurological disorder (FND). The term conversion disorder has faced limited acceptance from both nonpsychiatrists and patients. To address this issue and avoid an unproductive separation of the brain and mind, a more widely accepted and clinically applicable term was needed.

Therefore, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) proposed to use functional neurological disorder to diagnose symptoms like functional weakness or motor impairments, offering greater practical and theoretical utility and aligning with the concept of functional somatic symptoms, as advocated in The American Journal of Psychiatry 2010 article “Issues for DSM-5: Conversion Disorder.”

How common is conversion disorder?

Conversion disorder shows an annual incidence ranging between 4 to 12 cases per 100,000 people in the United States, as reported in the Brigham and Women’s Hospital’s Department of Rehabilitation Services Physical Therapy 2019 report on “Standard of Care: Functional Neurologic Disorder,”  The prevalence of FND was notably higher in women, constituting 60-75% of the total FND patient population.

Comparatively, the prevalence of conversion disorder is notably higher within neurology clinics, where it affects approximately 30% to 60% of patients. However, in the general population, its estimated prevalence is significantly lower, ranging only between 0.011% and 0.5%, as noted by the Global Emergency of Mental Disorders’ 2021 issue entitled “Somatic symptom disorder and related disorders”. The study also suggests that this disorder is more common in rural areas, particularly in socioeconomically disadvantaged populations.

What are the types of conversion disorders?

There are four specific types of conversion disorder, which are listed below.

• Those with motor symptoms or deficits: Individuals exhibiting this type of conversion disorder experience symptoms related to motor function, such as functional limb weakness/paralysis, tremors, spasms (dystonia), jerky movements (myoclonus) and problems walking (gait disorder), functional speech symptoms including whispering speech (dysphonia), and slurred or stuttering speech, as described in the National Organization for Rare Disorders’ (NORD) 2023 edition, titled “Functional Neurological Disorder“.
• Those with sensory symptoms or deficits: This type involves symptoms related to sensory functions, including numbness, tingling, or pain in the face, torso, or limbs, and loss of functional visual symptoms including loss of vision or double vision, as mentioned in the same source by NORD.
• Those with pseudo-seizures: This type encompasses individuals experiencing functional seizures (also known as dissociative or non-epileptic seizures) or episodes that resemble epileptic seizures but lack the typical neurological basis found in epilepsy. These episodes may include convulsions, altered consciousness, blackouts, and faints.
• Those with a mixed presentation: Individuals with a mixed presentation experience a combination of different types of symptoms mentioned above, such as a blend of motor, sensory, and pseudo-seizure-related symptoms.

What are the causes of conversion disorder?

The causes of conversion disorder are listed below.

• Childhood abuse
• Internal psychological conflicts
• Existing psychiatric disorders
• History of multiple somatic complaints
• Physical injury or neurologic illness
• Socioeconomic status

1. Childhood abuse

Childhood abuse refers to any form of mistreatment or harm experienced during a person’s childhood. This abuse can encompass various forms, such as physical, emotional, or sexual abuse, neglect, or witnessing domestic violence.

The connection between childhood abuse and conversion disorder is complex. According to the American Journal of Psychiatry 2006 issue on “Conversion disorder,”  many individuals with conversion disorder often have a history of past trauma or stress during their formative years and are inclined to prioritize emotional “strength” leading them to downplay emotional responses when dealing with challenging situations.

Although the traumatic incidents might have occurred in the past, the onset of physical symptoms typically happens later in response to new and sometimes less obvious triggering events.

Findings from the 2002 study titled “Childhood abuse in patients with conversion disorder”, published in The American Journal of Psychiatry, suggest a strong connection between childhood trauma, especially physical and sexual abuse, and the manifestation of conversion disorder. Patients with conversion disorder reported higher rates of physical and sexual abuse, longer duration of abuse, and instances of incest more frequently than other patients.

2. Internal psychological conflicts

Internal psychological conflicts refer to unresolved emotional or psychological tensions, often stemming from traumatic experiences, repressed feelings, or distressing events.

The 2019 issue of the Cureus journal titled “Conversion Disorder: The Brain’s Way of Dealing with Psychological Conflicts. Case Report of a Patient with Non-epileptic Seizures”, suggested that conversion disorder emerges when unconscious emotional conflicts are repressed and then transformed into physical symptoms.

Unlike epileptic seizures, psychogenic non-epileptic seizures do not result from an organic brain disease; instead, they are stress-induced and often stem from distressing psychological experiences, occasionally from forgotten past events. This disorder can be perceived as a method of physically expressing distress instead of managing it through normal emotional or cognitive processes.

3. Existing psychiatric disorders

Existing psychiatric disorders are mental health conditions that precede or coexist with conversion disorder.

FND often coexists with various conditions seen in neurological practice such as multiple sclerosis, stroke, and epilepsy, as emphasized in the 2023 edition of NORD, titled “Functional Neurological Disorder“.

Some individuals may have both FND and another neurological disease, requiring a neurologist to discern which symptoms align with FND. Anxiety, depression, and psychiatric conditions like Post-traumatic stress disorder (PTSD) are common in FND patients, sharing symptoms and potentially being linked to its development. Moreover, disorders like chronic pain, migraines, and functional syndromes such as irritable bowel syndrome might also be associated with FND.

4. History of multiple somatic complaints

The history of multiple somatic complaints refers to a pattern in which individuals consistently experience various physical symptoms or complaints without a clear medical explanation. These can include recurring issues such as pain, gastrointestinal distress, neurological symptoms, and other bodily complaints.

A 2019 study led by Fobian AD. et al., titled “A review of functional neurological symptom disorder etiology and the integrated etiological summary model”, published in the Journal of Psychiatry & Neuroscience, noted that between 57% and 82% of patients with FND have a history of other unexplained symptoms. Several experts suggested reasons for the prevalence of these somatic symptoms might stem from increased vigilance towards physical sensations, while impaired sensorimotor gating in FND patients indicates difficulty processing internal and external stimuli. Additionally, somatosensory amplification could contribute to the perception of normal sensations as extreme or injurious.

A case, described in the 2019 issue of the Cureus journal titled “Conversion Disorder: The Brain’s Way of Dealing with Psychological Conflicts. Case Report of a Patient with Non-epileptic Seizures,” involves a 41-year-old male with a multitude of psychiatric and physical complaints, who presented to the hospital with reported seizures and left-sided paralysis. Despite the patient’s claims of long-standing post-traumatic epilepsy and seizures, coronary artery disease, strokes, etc., examinations and tests revealed no evidence of neurological causes.

5. Physical injury or neurologic illness

Physical injury or neurologic illness refers to an actual injury or disease affecting the body’s nervous system. Physical injury may involve trauma, such as a head injury or spinal cord damage, while neurologic illness can encompass conditions like multiple sclerosis, stroke, or brain tumors that directly affect the functioning of the nervous system.

The 2019 study published in the Journal of Psychiatry & Neuroscience, titled “A review of functional neurological symptom disorder etiology and the integrated etiological summary model”, highlighted that a vast number of individuals with FND have a history of physical injury before the onset of the condition. The majority of patients with functional dystonia and functional weakness experienced physical injury proximate to the emergence of symptoms. This connection has been consistently observed since 1965, implying the potential role of physical trauma in the onset of FND.

Moreover, a considerable number of individuals with FND often have a history of neurological disorders or comorbid organic movement disorders and are more prone to having structural or functional brain abnormalities. 

6. Low socioeconomic status

Low socioeconomic status (SES) refers to a person or group’s position within a social and economic hierarchy, typically characterized by limited financial resources, reduced access to education and healthcare, exposure to adverse living conditions. It is often associated with poverty and economic disadvantage.

Various stressors associated with low socioeconomic status can contribute to increased stress and psychological pressure. High levels of stress and anxiety due to these factors may exacerbate the risk of developing or worsening the symptoms of conversion disorder in susceptible individuals.

According to Ali S. et al.’s 2015 study titled “Conversion Disorder – Mind versus Body: A Review”, published in the Innovations in Clinical Neuroscience journal, individuals with lower levels of education and lower socioeconomic status are at a higher risk of developing conversion disorder. There is a notable difference between populations in developing and developed nations; in developing countries, the prevalence of conversion disorder can be as high as 31%.

What are the symptoms of conversion disorder?

The symptoms of conversion disorder are listed below.

• Weakness or paralysis
• Abnormal movements
• Balance problems
• Vision problems (blindness)
• Hearing problems
• Numbness and loss of sensation
• Paresthesia
• Difficulty or inability to speak
• Difficulty swallowing

1. Weakness or paralysis

Weakness or paralysis refers to a loss or reduction in the ability to move or control muscles in a certain part of the body. Individuals diagnosed with conversion disorder frequently demonstrate weakness when instructed to turn their heads toward the affected side, while those affected by an organic disease typically do not display this specific weakness.

In cases of conversion paralysis, the patient experiences the loss of function in half of their body or a single limb. However, this paralysis does not adhere to typical anatomical patterns and is frequently inconsistent during repeated examinations, as stressed in the 2019 study by Cureus Journal, titled “Conversion Disorder: The Brain’s Way of Dealing with Psychological Conflicts. Case Report of a Patient with Non-epileptic Seizures”. 

2. Abnormal movements

Abnormal movements refer to involuntary or irregular motions or gestures that deviate from what is considered typical or expected. Individuals with conversion disorder might experience abnormal movements that are not attributed to typical neurological patterns. These movements are not purposely feigned, and they can manifest as jerking, tremors, or other unusual motor behaviors without a clear neurological explanation.

The 2010 study by Voon V. et al., titled “The involuntary nature of conversion disorder” and published in Neurology, detailed that in conversion disorders, the movements manifest along usual voluntary motor pathways but are oddly perceived as involuntary, lacking the sense of self-control, which aligns with the symptomatology of this condition. The absence of self-agency—where individuals feel disconnected from causing their actions—is a notable feature seen in patients with conversion disorder.

3. Balance problems

Balance problems refer to difficulties in maintaining stability or equilibrium, often resulting in unsteadiness or dizziness, affecting tasks involving motor skills, and contributing to difficulties in walking or maintaining a stable posture.

As per The Brigham and Women’s Hospital’s 2019 publication titled “Standard of Care: Functional Neurologic Disorder”, individuals with FND might also display issues with coordination. Researchers recommend that for a thorough coordination assessment medical professionals should conduct evaluations of rapid alternating movements, accuracy in touching the finger to the nose or a specific target, and stability in posture.

4. Vision problems (blindness)

Vision problems encompass a range of issues affecting sight. Vision symptoms are part of FND and can involve alterations in vision, such as blurred vision, double vision, increased sensitivity to light (photophobia), and partial or complete loss of vision (blindness), as described in the NHS Inform 2023 edition, titled “Functional neurological disorder”.

As per StatPearls’ 2023 edition on “Conversion Disorder”, complete blindness in a patient with conversion disorder might suggest the possibility of factitious symptoms. Usually, individuals with conversion disorder maintain their pupillary reflex. However, those newly diagnosed with complete blindness may encounter difficulties with mobility, increasing the chance of injuries, visible bruising, or wounds, while such physical signs are typically not present in patients with CD.

5. Hearing problems

Hearing problems refer to difficulties or abnormalities related to one’s ability to hear or perceive sound. Conversion deafness, identified as a somatoform disorder, is characterized by a loss of hearing without a detectable physical or pathophysiological cause, as defined in a 2006 study by Wang YP. et al., titled “Conversion deafness presenting as sudden hearing loss”. 

In a 2022 “Case Report of Non-Organic Hearing Loss: Literature Review” by Tingting Yu et al., published in Prime Scholars, it was highlighted that factors implicated in the onset of non-organic hearing loss (NOHL) encompass depression, personality disorder, anxiety, and a past history of conversion disorder. Neuroimaging investigations of conversion disorder have revealed distinct activity patterns in various brain regions. The diminished activity in the thalamus is proposed as a potential factor leading to decreased sensory perception, possibly contributing to the heightened hearing thresholds often noted in many NOHL patients during their initial evaluation.

6. Numbness and loss of sensation

Numbness and loss of sensation is the absence or reduction of an individual’s ability to perceive sensations, such as touch, temperature, or pressure. People with CD genuinely feel numbness in a particular body part or region, despite no identifiable nerve damage or neurological cause.

The 2021 article titled “Functional neurological disorder in the emergency department,” and published in the Academic Emergency Medicine journal, highlighted that sensory symptoms within FND vary, ranging from pain or experiencing a “pins and needles” sensation to feelings of heaviness or numbness.

7. Paresthesia

Paresthesia refers to abnormal sensations experienced in the body, often described as tingling, burning, or prickling feelings. Paresthesia is one of the sensory symptoms or disturbances commonly observed in conversion disorder.

According to the 2023 publication from the Sheffield Teaching Hospitals NHS Foundation Trust in the UK discussing “Functional Neurological Disorders (FNDs),” both “positive” and “negative” sensory symptoms can pose significant challenges for individuals. Those with FND often encounter “sensory overload,” which extends to discomfort with temperature variations, and individuals may also endure unpleasant sensations on their skin, like tingling, prickling, or pain.

8. Difficulty or inability to speak

Difficulty or inability to speak is when an individual faces challenges in speech production, struggles in word retrieval, unintentional word mix-ups, or experiences a complete loss of the ability to vocalize.

StatPearls’ 2023 edition on “Conversion Disorder” suggested that conversion disorder can manifest various speech impairments, primarily functional dysphonia, often characterized by speaking in a whisper or hoarse voice, despite the absence of any known medical causes. Additionally, it can manifest as difficulties in articulation, slurred speech, stuttering, foreign accent syndrome, and mutism.

9. Difficulty swallowing

Difficulty swallowing, medically known as dysphagia, is a sensation or actual impairment that hinders the normal passage of food and liquids from the mouth to the stomach. This can manifest as a feeling of a lump in one’s throat or actual difficulty moving food down the esophagus.

As described in the FND Guide’s 2021 issue, titled “Functional Speech Swallowing Symptoms,” individuals with FND might feel as if something is lodged in their upper throats. This symptom is known as globus sensation or globus pharyngeus, and it can cause swallowing difficulty, even when not consuming food.

Who is affected by conversion disorder?

Adult women are more frequently affected by conversion disorder, surpassing adult men in a ratio varying between 2:1 to 10:1, as revealed by Jessica L. Peeling and Maria Rosaria Muzio in their research on “Conversion Disorder,” published in StatPearls‘ 2023 edition. 

Individuals from lower socioeconomic backgrounds with lower levels of education tend to experience higher incidences of conversion disorder, while race does not seem to play a significant role, mentioned the research.

What are the risk factors for conversion disorder?

The risk factors for conversion disorder are listed below.

• Psychological factors: Stressful life events, trauma, or emotional distress, such as conflicts or significant life changes, can increase the likelihood of developing conversion disorder. As outlined in a recent 2023 article from verywellmind, named “Conversion Disorder: Symptoms, Causes, Treatment,” this disorder could potentially stem from a psychological response triggered by significant stress or emotional trauma. For instance, in the case of a soldier, who subconsciously wants to avoid firing a gun, this psychological conflict might lead to the development of paralysis in his hand.
• Childhood trauma or abuse: In their 2012 study titled “Functional (Conversion) Neurological Symptoms: Research Since the Millennium,” published in the Journal of Neurology, Neurosurgery & Psychiatry, Carson A. J. et al. emphasized that individuals with functional neurological symptoms commonly have a history of adverse childhood experiences, including but not limited to sexual abuse.
• Environmental and social factors: The LibreTexts 300.11 resource discussing “Conversion disorder” emphasized the connections between this condition and cultural influences by pointing out that individuals in rural areas, with lower socioeconomic status, and limited exposure to psychology and medicine are diagnosed with conversion disorder more frequently than other groups. There is a higher prevalence of conversion disorder in developing regions compared to developed areas, and as these developing regions progress, reports of this disorder tend to decrease. The symptoms exhibited by patients with conversion disorder may differ based on culturally accepted ways of expressing distress.
• Genetic and family history: As per verywellmind’s 2023 article on “Conversion Disorder: Symptoms, Causes, Treatment,” being closely related to someone diagnosed with conversion disorder might pose a potential risk for developing this condition. Especially females, who have a first-degree female relative, such as a sister, mother, or daughter, with conversion disorder are more prone to experiencing similar symptoms compared to females in the general population.
• Physical Illness or injury: Linden SC. in her 2020 study titled “Triggers and Clinical Presentations of Functional Neurological Disorders: Lessons from World War 1,” published in the European Neurology journal, discovered that for approximately two-thirds of cases involving conversion disorder triggers were associated with accidents, physical illnesses, work-related stress, and the combat experiences of soldiers. The nature of these triggers plays a crucial role in shaping the expression of symptoms. This implies that the type and intensity of the trigger can significantly influence the specific symptoms exhibited by patients with CD, potentially amplifying the manifestation of motor-related issues in highly stressful situations.
• Sex and age: As discussed in the previous paragraphs, adult females may present a higher risk of developing conversion disorder than males.

How is conversion disorder diagnosed?

Conversion disorder is diagnosed through a thorough clinical evaluation by a qualified healthcare professional, typically a neurologist or psychiatrist. The diagnosis involves a comprehensive examination of the patient’s medical history, physical symptoms, and a careful exclusion of any known neurological or medical conditions that could account for the observed symptoms.

The DSM-5 offers specific criteria for diagnosing conversion disorder, including one or more symptoms of altered voluntary motor or sensory function, clinical findings that provide evidence of incompatibility between the symptom and recognized neurological or medical conditions, the cases when the symptoms or deficits cannot be better explained by another medical or mental disorder, and when the symptom or deficit results in clinically significant distress or impairment in social, occupational, or other vital areas of functioning or warrants medical evaluation.

An acute episode of conversion disorder is characterized by the existence of these symptoms that last for about six months, while persistent conversion disorder entails symptoms persisting for more than six months.

When does conversion disorder occur?

Conversion disorder commonly occurs during late childhood or early adulthood, reaching its peak onset in individuals in their mid to late 30s. Although it can manifest at any age, it is uncommon among children under 10 years old and the elderly, as discussed in the 2021 issue of the Global Emergency of Mental Disorders, which focuses on “Somatic symptom disorder and related disorders.”

Conversion disorder can manifest at any stage of life, with certain symptoms tending to be more prevalent during particular age brackets, like motor symptoms occurring commonly in one’s 30s and non-epileptic attacks (dissociative seizures) in the 20s, as outlined by Psychology Today’s 2021 article on “Conversion Disorder”.

What are the treatments for conversion disorder?

The treatments for conversion disorder are listed below.

• Psychotherapy
• Physical therapy
• Hypnosis
• Pharmacotherapy

1. Psychotherapy

Psychotherapy, also known as talk therapy or counseling, is a collaborative treatment method that involves discussions between an individual and a trained mental health professional, aimed at helping people understand their emotions, thoughts, behaviors, and the influences of past experiences on their current mental health.

According to Hallett M. et al. ‘s 2022 study titled “Functional Neurological Disorder: New Phenotypes, Common Mechanisms,” published in the Lancet Neurology journal, different types of psychotherapy have been evaluated for FND, particularly for functional seizures. Studies and case series have shown that 82% of patients experienced a 50% reduction in seizure frequency right after psychotherapy. 

A few controlled trials highlighted that psychotherapy based on cognitive behavioral therapy (CBT) was more beneficial for decreasing seizure frequency within 6 months compared to standard medical treatment.

2. Physical therapy

Physical therapy or physiotherapy (PT) is a healthcare discipline focused on helping individuals regain or improve their physical abilities and movements. It involves using exercise, manual therapy, and other specialized techniques.

As per the article titled “Physical therapies (physiotherapy & occupational therapy)” by FND Hope, physiotherapy is beneficial for individuals experiencing symptoms that impact voluntary movement, such as weakness, tremors, dystonia, and issues related to walking and balance. The primary goal of physiotherapy involves retraining movement patterns and reinstating normal automatic function.

Certain studies have indicated that physical rehabilitation, tailored to understanding FND, has led to symptom improvement in approximately 60 to 70 percent of individuals.

3. Hypnosis

Hypnosis is the induction of a trance-like state to enhance focus, concentration, and suggestibility in an individual. Hypnosis is sometimes used as a therapeutic tool for patients with FND to help manage certain symptoms.

In the section on Hypnosis therapy within the FND Hope article titled “Psychological Treatments,” Dr. Sepideh Bajestan suggests that the primary hypnotherapy technique used for treating functional movement disorders is the “split screen technique.” In this method, the patient initiates a typical event, gaining control to start and stop the movement dysfunction. Patients are educated about recognizing warning signs and mastering the sequence of triggers leading to functional movements or seizures. They are taught self-hypnosis for preventing or stopping the movement dysfunction promptly.

Hypnosis is especially beneficial in treating individuals with speech or sensory loss. Its effectiveness can vary among individuals, and it should be used as a complementary or secondary approach to standard treatments for FND.

4. Pharmacotherapy

Pharmacotherapy is the use of medications to manage or treat various medical conditions. Pharmacotherapy is not considered the primary treatment for conversion disorder, as it is primarily regarded as a condition with psychological origins. However, the medical expert may prescribe an anti-anxiety medication or antidepressant to treat the underlying stress and anxiety.

According to the Mater Centre for Neurosciences learning guide on “Functional Neurological Disorder (FND)”, the use of medications in the treatment of FND is generally minimized, as it may be met with reluctance by many patients due to psychiatric stigma, concerns about addiction and side effects.

However, certain antidepressants have shown benefits, even for individuals without concurrent mental health issues. Tricyclic antidepressants can assist those experiencing insomnia and pain, while serotonin reuptake inhibitors are more effective for hypersomnia but less so for pain management. Neuropathic analgesics like gabapentin or pregabalin are used for chronic pain.

As reported in the 2023 NHS Inform article on “Functional Neurological Disorder,” a healthcare professional should assess whether medication is suitable for the specific situation or not, since certain medications, such as opiates like morphine, dihydrocodeine, or codeine, could potentially exacerbate FND. 

Can you prevent conversion disorder?

No, you cannot entirely prevent conversion disorder as its precise causes are not yet fully understood. While it might not be fully preventable, early identification of stressors, prompt intervention, and seeking appropriate psychological support can contribute to minimizing the risk and impact of conversion disorder.

In their 2021 study titled “Functional Neurologic Disorders: The Need for a Model of Care,” O’Neal MA. et al., also highlighted that a timely and accurate diagnosis of FND holds critical implications for healthcare and has the potential to improve patient outcomes. Preventing conversion disorder should involve identifying and promptly treating individuals at risk. 

What to expect with conversion disorder?

One should expect a range of unexplained neurological symptoms affecting movement or sensory functions in cases of conversion disorder. These symptoms may include paralysis, weakness, seizures, or sensory disturbances like blindness or numbness, often appearing suddenly and significantly impacting daily functioning.

According to the 2023 study by StatPearls on “Conversion Disorder,” the overall outlook for this condition is not quite promising, but several factors influence the prognosis. Positive indicators for a better prognosis encompass a sudden symptom onset, early diagnosis, brief symptom duration, absence of accompanying psychiatric disorders (particularly personality disorders), identifiable stress factors, and a favorable patient-clinician relationship. Patients presenting with more physical symptoms of impaired functioning before diagnosis are more likely to have an unfavorable outcome.

In the 2012 study by Carson A. J. et al., titled “Functional (Conversion) Neurological Symptoms: Research Since the Millennium,” the experts highlighted the challenges in achieving recovery from conversion disorder, particularly in cases of chronic symptoms. They also revealed that patients’ expectations of non-recovery, the absence of attributing symptoms to psychological factors and receiving health-related benefits at the initial consultation are significant predictors of poor prognosis.

What is the difference between conversion disorder and factitious disorder?

The difference between conversion disorder and factitious disorder lies in their distinct nature of symptom manifestation.

According to the 2018 article by Frontiers of Neurology and Neuroscience, titled “Conversion, Factitious Disorder and Malingering: A Distinct Pattern or a Continuum?,” conversion disorder is characterized by the unintentional display of neurological symptoms, causing significant distress or impairment, while factitious disorder involves intentionally simulated or fabricated symptoms by the individual, seeking the sick role and medical attention without any clear external benefit.

What is the difference between conversion disorder and somatic symptom disorder?

The difference between conversion disorder and somatic symptom disorder lies in their distinct impact on the central nervous system and the nature of symptoms.

As per Mind Diagnostics’ 2023 November issue on “Conversion Disorder vs. Somatic Symptom Disorder Explained,” somatic symptom disorder impacts the central nervous system differently from conversion disorder, and they both manifest symptoms differently.

Somatic symptom disorder is a complex psychiatric condition characterized by the presence of one or more distressing and often disabling physical symptoms. These symptoms might range from pain, exhaustion, and gastrointestinal issues to neurological issues or sensory impairments.

Conversion disorder predominantly presents neurological symptoms like paralysis, weakness, or sensory disruptions, which lack explanation through medical or neurological causes and are believed to stem from psychological stress or conflict.

What is the difference between conversion disorder and illness anxiety disorder?

The difference between conversion disorder and illness anxiety disorder is in their primary characteristics and focus on symptoms.

Conversion disorder involves symptoms impacting motor or sensory function, such as weakness or sensory disturbances, without medical explanation and unintentional fabrications. In contrast, illness anxiety disorder centers around an excessive preoccupation with believing or fearing having a severe, undiagnosed illness, regardless of medical reassurance.

As outlined in a 2018 Medscape article titled “Illness Anxiety Disorder (formerly Hypochondriasis) Differential Diagnoses”, unlike illness anxiety disorder, patients with conversion disorder generally are not concerned about having a serious disease and may demonstrate a notable lack of worry, even about the symptom they are experiencing.