Conversion Disorder

Conversion Disorder (CD) typically involves only a single dramatic symptom that arises immediately or soon after a major traumatic event. CD was called "hysteria" in earlier times, and was thought to occur almost exclusively in women. The word "hysteria," which was derived from the Greek word for wandering uterus, reflected this feminine connection. The disorder is diagnosed less frequently in our more sophisticated era. Freud based his initial version of psychoanalysis on a case of hysteria, that of "Anna O.," who developed a series of conversion symptoms connected with the death of her father.

The idea behind the name "CD" is that a psychological problem is converted into a physical symptom. Some symptoms include blindness or partial blindness, deafness, paralysis, and numbness. Before CD is diagnosed, a careful physical examination is needed. The evidence that a significant psychological stressor brought on the disorder should be strong. In some cases the symptom is inconsistent with a physical explanation; the classical case is that of "glove anesthesia," wherein the pattern of numbness is inconsistent with the distribution of nerves.

Males and females are about equally likely to be diagnosed with CD. The stresses of war produce some of the cases in males. In many cases of CD some benefits flow from the symptom; for example, a soldier cannot fire a gun if his dominant hand is paralyzed. Most cases of CD resolve themselves in a period of weeks to months. If they do not, the patient should be reevaluated very carefully to be certain that a physical cause, after all, did not bring about the problem. However, the usual therapy is support and reassurance while waiting for spontaneous remission.

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