GeneHealth - Your precision medicine

Conversion Disorder

Disease Details

Family Health Simplified

Buy Membership

Description: Conversion disorder is a neurological condition where psychological stress manifests as physical symptoms, such as paralysis or blindness, without a medical cause.
Type: Conversion disorder is classified as a type of somatic symptom and related disorder. It is not considered to have a genetic transmission, as it primarily results from psychological factors.
Signs And Symptoms: Conversion disorder begins with some stressor, trauma, or psychological distress. Usually the physical symptoms of the syndrome affect the senses or movement. Common symptoms include blindness, partial or total paralysis, inability to speak, deafness, numbness, difficulty swallowing, incontinence, balance problems, seizures, tremors, and difficulty walking. The symptom of feeling unable to breathe, but where the lips are not turning blue, can indicate conversion disorder or sleep paralysis. Sleep paralysis and narcolepsy can be ruled out with sleep tests. These symptoms are attributed to conversion disorder when a medical explanation for the conditions cannot be found. Symptoms of conversion disorder usually occur suddenly. Conversion disorder is typically seen in people aged 10 to 35, and affects between 0.011% and 0.5% of the general population.Conversion disorder can present with motor or sensory symptoms including any of the following:
Motor symptoms or deficits:

Impaired coordination or balance
Weakness/paralysis of a limb or the entire body (hysterical paralysis or motor conversion disorders)
Impairment or loss of speech (hysterical aphonia)
Difficulty swallowing (dysphagia) or a sensation of a lump in the throat
Urinary retention
Psychogenic non-epileptic seizures or convulsions
Persistent dystonia
Tremor, myoclonus or other movement disorders
Gait problems (astasia-abasia)
Loss of consciousness (fainting)Sensory symptoms or deficits:

Impaired vision (hysterical blindness), double vision
Impaired hearing (deafness)
Loss or disturbance of touch or pain sensationConversion symptoms typically do not conform to known anatomical pathways and physiological mechanisms. It has sometimes been stated that the presenting symptoms tend to reflect the patient's own understanding of anatomy and that the less medical knowledge a person has, the more implausible are the presenting symptoms. However, no systematic studies have yet been performed to substantiate this statement.Sexual dynsfunction and pain are also symptoms of conversion disorder but if a patient only has these symptoms, they should be diagnosed with sexual pain disorder or pain disorder.
Prognosis: Empirical studies have found that the prognosis for conversion disorder varies widely, with some cases resolving in weeks, and others enduring for years or decades. There is also evidence that there is no cure for conversion disorder, and that although patients may go into remission they can relapse at any point. Furthermore, many patients can get rid of their symptoms with time, treatments and reassurance.
Onset: The onset of conversion disorder typically occurs in late childhood to early adulthood. It often arises suddenly, usually in the context of stress or trauma. There is no specific numerical answer (nan) associated with its onset.
Prevalence: The prevalence of conversion disorder, also known as functional neurological symptom disorder, varies widely but is estimated to occur in approximately 2 to 5 people per 100,000 annually. It may be more common in certain populations, such as those with lower socioeconomic status or individuals experiencing significant psychological stress.
Epidemiology: Conversion disorder, also known as functional neurological symptom disorder, is characterized by neurological symptoms that are inconsistent with or cannot be fully explained by medical or neurological conditions. The epidemiology of conversion disorder shows:

1. **Prevalence**: Estimated lifetime prevalence is roughly 0.011% to 0.5%, though it can be higher in medical and neurological clinics.
2. **Gender**: More common in females, with a female-to-male ratio ranging from 2:1 to 10:1.
3. **Age**: Can occur at any age but is more frequently diagnosed in late childhood to early adulthood.
4. **Socioeconomic Status**: Often associated with lower socioeconomic status, lower levels of education, and those with a history of psychological trauma or stress.
5. **Comorbidity**: Frequently coexists with other psychiatric conditions such as depression, anxiety disorders, and somatic symptom disorders.

Nan does not seem applicable in this context since it does not align with typical epidemiological data points.
Intractability: Conversion disorder, also known as functional neurological symptom disorder, involves neurological symptoms that cannot be fully explained by medical conditions. While it can be challenging to treat, it is not necessarily intractable. Various therapies, such as cognitive behavioral therapy (CBT), physical therapy, and medications for associated conditions (e.g., depression or anxiety), can help manage and potentially alleviate symptoms. The success of treatment often depends on the patient's engagement, the healthcare provider's expertise, and the presence of any co-occurring psychological or medical issues.
Disease Severity: Disease severity for conversion disorder can vary widely among individuals. Some people may experience mild symptoms that resolve quickly, while others may have severe and chronic symptoms that significantly impair their daily functioning. The severity often correlates with the level of stress or psychological conflict the person is experiencing.
Healthcare Professionals: Disease Ontology ID - DOID:1768
Pathophysiology: The pathophysiology of conversion disorder, also known as functional neurological symptom disorder, is not fully understood. It involves complex interactions between psychological factors and brain function. Neuroimaging and neurophysiological studies suggest that patients with conversion disorder may exhibit abnormalities in brain regions associated with emotion regulation, particularly the prefrontal cortex, limbic system, and motor/sensory areas. Some theories propose that the disorder may result from disruptions in the brain's ability to process and regulate emotional or psychological stress, leading to physical symptoms. The exact mechanisms remain a topic of ongoing research.
Carrier Status: Conversion disorder does not involve carrier status. Conversion disorder, also known as functional neurological symptom disorder, involves neurological symptoms such as paralysis, movement disturbances, or sensory issues that are not explained by a medical condition. It is considered a psychological condition with no genetic or hereditary carrier state.
Mechanism: Conversion disorder, also known as functional neurological symptom disorder, involves neurological symptoms that cannot be fully explained by a medical condition or neurological disease. While the precise mechanism underlying conversion disorder is not fully understood, it is generally believed to be related to psychological stress or trauma that manifests physically.

**Mechanism:**
1. **Psychological Basis:** Conversion disorder is thought to arise when psychological stress or conflict is "converted" into physical symptoms. This can include symptoms such as paralysis, tremors, gait abnormalities, or non-epileptic seizures.
2. **Neurological Dysfunction:** Some studies suggest that abnormalities in the functioning of neural circuits, particularly those involving the limbic system (which processes emotions) and areas responsible for motor and sensory functions, may contribute to the disorder.

**Molecular Mechanisms:**
1. **Neurotransmitter Imbalance:** Research has indicated that there might be imbalances in neurotransmitters such as serotonin, norepinephrine, and dopamine, which are involved in regulating mood, anxiety, and neurological function.
2. **Hypothalamic-Pituitary-Adrenal (HPA) Axis:** Dysregulation of the HPA axis, which controls the body’s stress response, may play a role. Elevated or dysregulated cortisol levels, which are part of the body's response to stress, have been associated with conversion symptoms.
3. **Functional Neuroimaging:** Functional MRI (fMRI) and PET scans have shown altered activity in brain regions associated with emotion regulation, such as the anterior cingulate cortex, insula, and prefrontal cortex, as well as decreased connectivity between these regions and motor/sensory areas.

These findings suggest that conversion disorder is a complex interplay of psychological and biological factors, involving disrupted communication between brain regions that govern emotions and those that control movement and sensation.
Treatment: There are a number of different treatments available to treat and manage conversion syndrome. Treatments for conversion syndrome include hypnosis, psychotherapy, physical therapy, stress management, and transcranial magnetic stimulation. Treatment plans will consider duration and presentation of symptoms and may include one or multiple of the above treatments. This may include the following:
Occupational therapy to maintain autonomy in activities of daily living;
Physiotherapy where appropriate.
Treatment of comorbid depression or anxiety if present.
Educating patients on the causes of their symptoms might help them learn to manage both the psychiatric and physical aspects of their condition. Psychological counseling is often warranted given the known relationship between conversion disorder and emotional trauma. This approach ideally takes place alongside other types of treatment.There is little evidence-based treatment of conversion disorder. Other treatments such as cognitive behavioral therapy, hypnosis, EMDR, and psychodynamic psychotherapy, EEG brain biofeedback need further trials. Psychoanalytic treatment may possibly be helpful. However, most studies assessing the efficacy of these treatments are of poor quality and larger, better controlled studies are urgently needed. Cognitive Behavioural Therapy is the most common treatment, however boasts a mere 13% improvement rate.
Compassionate Use Treatment: Conversion disorder, also known as functional neurological symptom disorder, typically involves symptoms that affect motor or sensory functions, which cannot be explained by medical conditions. Treatments are primarily focused on psychological interventions. Compassionate use treatment, off-label, or experimental treatments are not commonly associated with conversion disorder as first-line therapies; however, research and clinical practice occasionally explore alternative approaches.

For compassionate use treatments, options are quite limited and would typically be considered on a case-by-case basis under strict medical supervision.

Off-label or experimental treatments for conversion disorder might include:
1. **Medications**: Certain antidepressants, antipsychotics, or anxiolytics used off-label to address comorbid mental health conditions, such as depression or anxiety, which could potentially alleviate some conversion disorder symptoms.
2. **Neuromodulation Techniques**: Transcranial magnetic stimulation (TMS) and vagus nerve stimulation (VNS) have been explored in experimental settings to treat neurological and psychiatric components of conversion disorder.
3. **Emerging Psychotherapies**: Novel psychotherapeutic approaches, including various forms of cognitive-behavioral therapy (CBT) and mindfulness-based therapies, are continually evaluated in clinical trials to determine their efficacy for conversion disorder.

It's essential for any off-label or experimental treatments to be overseen by healthcare professionals with expertise in functional neurological disorders.
Lifestyle Recommendations: For individuals with conversion disorder, the following lifestyle recommendations can be beneficial:

1. **Regular Physical Activity**: Engage in regular, moderate exercise to help reduce stress and improve overall well-being.
2. **Healthy Diet**: Maintain a balanced diet rich in fruits, vegetables, whole grains, and lean proteins to support overall health.
3. **Stress Management**: Practice stress-reduction techniques such as yoga, meditation, and deep breathing exercises.
4. **Adequate Sleep**: Ensure proper sleep hygiene and aim for 7-9 hours of sleep per night.
5. **Psychotherapy**: Cognitive-behavioral therapy (CBT) or other forms of psychotherapy can help address underlying psychological issues.
6. **Social Support**: Maintain strong social connections with friends and family to provide emotional support.
7. **Avoid Substance Abuse**: Refrain from using alcohol, drugs, and other substances as coping mechanisms.
8. **Routine Medical Follow-ups**: Regularly consult with healthcare providers to monitor symptoms and adjust treatment plans as needed.
Medication: Conversion disorder, also known as functional neurological symptom disorder, typically focuses on psychotherapy as the primary treatment. Medication is not typically the first line of treatment, but it might be used to address concurrent issues such as anxiety or depression. Selective serotonin reuptake inhibitors (SSRIs) and other antidepressants may sometimes be prescribed to alleviate these underlying conditions. It's essential to work closely with a healthcare professional to develop an appropriate treatment plan.
Repurposable Drugs: Conversion disorder, also known as functional neurological symptom disorder, involves neurological symptoms that are inconsistent with or cannot be fully explained by medical conditions. There are no well-established repurposable drugs specifically for conversion disorder. Treatment typically focuses on psychotherapy, particularly cognitive-behavioral therapy (CBT). Medications may be prescribed to manage co-occurring conditions like anxiety or depression but are not targeted directly at conversion disorder.
Metabolites: Conversion disorder, also known as functional neurological symptom disorder, involves neurological symptoms that cannot be explained by medical or neurological conditions. It typically manifests as symptoms such as paralysis, tremors, or non-epileptic seizures.

There are no specific metabolites identified for diagnosing conversion disorder, as the condition is primarily diagnosed based on clinical evaluation and the exclusion of other medical causes. Therefore, in the context of "metabolites," there is no relevant information (nan: not applicable/nan).
Nutraceuticals: There is limited evidence to support the use of nutraceuticals in the treatment of conversion disorder, also known as functional neurological symptom disorder. Conversion disorder is typically managed with a combination of psychotherapy, particularly cognitive-behavioral therapy (CBT), and physical or occupational therapy. Nutraceuticals are not typically recommended as a primary treatment for this condition.
Peptides: Peptides and nanotechnology do not directly relate to the conventional understanding or treatment of conversion disorder, a mental health condition characterized by neurological symptoms without a neurological cause, such as paralysis, blindness, or movement disorders. Conversion disorder is typically managed through psychotherapy, such as cognitive-behavioral therapy (CBT), and sometimes medication to treat underlying conditions like anxiety or depression. Peptides and nanotechnology are more commonly associated with biomedical research and treatment for other physical health conditions.