Conversion disorder is a mental health condition where emotional problems are converted into physical symptoms. Common symptoms include paralysis, blindness, seizures, swallowing difficulties, motor tics and difficulty walking. These physical symptoms cannot be explained by an underlying neurological or medical health condition.
The effects of conversion disorder go beyond physical and psychological distress. Approximately 82% of people with conversion disorder stop working due to symptoms. This loss in productivity adds up to $20 billion USD spent annually on this condition. Diagnosis can prove difficult as well, as conversion disorder can co-exist with physical illness in 60% of patients.
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Prevalence of Conversion Disorder
The basis of conversion disorder symptoms stems from psychological problems that could be from current or past unresolved issues. Conversion disorder can be triggered by physical, emotional or sexual abuse. Research indicates that risk factors include being part of a rural population, lacking education, being female, being lower socioeconomic status and being young.
Statistics show that conversion disorder prevalence is significant in the United States:
- Lifetime prevalence rates of conversion disorder are between 11–300 per 100,000 people
- 5–14% of general hospital patients are diagnosed with conversion disorder
- 1–3% of outpatient referrals to psychiatrists are diagnosed with conversion disorder
- 5–25% of psychiatric outpatients are diagnosed with conversion disorder
- An estimated 20–25% of those in a hospital setting meet some of the criteria for conversion disorder diagnosis
- Conversion disorders are more common in adult women than men, with at least twice the number of women diagnosed with conversion disorder than men
- Conversion disorders are more common in populations of individuals that have less education and lower socioeconomic status
- Compared to developed countries, third-world or developing countries can have up to a 31% prevalence rate
Occurrence of Misdiagnosis
A large number of people with conversion disorder also have a co-occurring medical condition, making it difficult to receive a diagnosis. A thorough psychiatric evaluation is required to obtain a detailed medical history, including onset of symptoms, co-occurring conditions and other stress factors. This general health workup is also necessary to rule out any physical illness that the symptoms of a conversion disorder may mimic.
Conversion disorder symptoms are often mistaken for the following health conditions:
- Multiple sclerosis
- Myasthenia gravis
- Periodic paralysis
- Spinal cord injury
In addition to ruling out physical health conditions, other psychological disorders should be ruled out as well before a diagnosis of conversion disorder is given, including:
- Factitious disorder
The failure to diagnose conversion disorder can have negative consequences for the affected individual and delay vital treatment.
Rates of Conversion Disorder and Co-Occurring conditions
Conversion disorder can occur alongside other mental health conditions. These co-occurring conditions must also be treated for the best possible outcome.
Some of the most common conditions that co-occur with conversion disorder include:
- Depression: In one study depression and conversion disorder occurred together in 29% of people
- Anxiety: Research shows that conversion disorder and anxiety occurred together in about 35% of cases
- Dissociative Disorders: Both dissociative disorders and conversion disorder can develop after childhood trauma
- PTSD: PTSD has at least one traumatic event that triggers the condition; conversion disorder can also stem from trauma or stressors
Conversion Disorder Prognosis
Conversion disorder prognosis is best when the symptoms have an acute onset, short duration, a known trigger or stressor, and no other co-occurring conditions. Receiving treatment from a qualified therapist also dramatically improves conversion disorder prognosis. Most acute onsets of conversion disorder resolve within weeks, but 25% of people who have acute conversion disorder symptoms also have recurring symptoms within a year.
Prognosis outlook is diminished when conversion disorder has been present for over a year with recurring symptoms. Comorbidity may also be increased among those who have symptoms lasting over a year.
Statistics on Conversion Disorder Treatment
The best treatment for conversion disorder starts with how the diagnosis is presented to the affected individual. Because the symptoms are causing physical and neurological disabilities, telling someone “it’s all in their head” can make symptoms worse. At the same time, conversion disorder treatment success is reliant on the person recognizing the psychological connection to their physiological symptoms.
Effective treatment for conversion disorder includes:
- Psychotherapy: Methods like cognitive behavioral therapy and group can be employed to shed light on underlying emotions and methods of coping
- Physical therapy: Research shows this to be an effective method of treatment to help the person overcome their physical symptoms
- Medications: While no medication can treat conversion disorder alone, medication can help address the underlying symptoms of co-occurring conditions, like depression or anxiety
If you or someone you know lives with co-occurring conversion disorder and addiction, we encourage you to get in touch with us at The Recovery Village. Contact us today to discuss possible treatment options.
Ali, S., et al. “Conversion Disorder—Mind Versus Body: a Review.” Innovations in Clinical Neuroscience, May-June 2015. Accessed April 21, 2019. Marshall, S.A., Landau, M.E., Carroll, C.G., Schwieters, B., and Llewellyn, A. “Conversion Disorders.” Medscape Reference, November 9, 2109. Accessed April 21, 2019. Minddisorders.com. “Conversion disorder.” 2019. Accessed April 21, 2019. Stone, J., Zeidler, M., Sharpe, M. “Misdiagnosis of Conversion Disorder.” American Journal of Psychiatry, February 1, 2003. Accessed April 21, 2019. Khan, M.N., Ahmad, S., Arshad, N., Ullah, N., Maqsood, N. “Anxiety and Depressive Symptoms in Patients With Conversion Disorder.” Journal of the College of Physician and Surgeons, August 15, 2005. Accessed April 21, 2019. Feinstein, A. “Conversion Disorder: Advances in Our Understanding.” CMAJ, May 17, 2011. Accessed April 21, 2019.
Ali, S., et al. “Conversion Disorder—Mind Versus Body: a Review.” Innovations in Clinical Neuroscience, May-June 2015. Accessed April 21, 2019.
Marshall, S.A., Landau, M.E., Carroll, C.G., Schwieters, B., and Llewellyn, A. “Conversion Disorders.” Medscape Reference, November 9, 2109. Accessed April 21, 2019.
Minddisorders.com. “Conversion disorder.” 2019. Accessed April 21, 2019.
Stone, J., Zeidler, M., Sharpe, M. “Misdiagnosis of Conversion Disorder.” American Journal of Psychiatry, February 1, 2003. Accessed April 21, 2019.
Khan, M.N., Ahmad, S., Arshad, N., Ullah, N., Maqsood, N. “Anxiety and Depressive Symptoms in Patients With Conversion Disorder.” Journal of the College of Physician and Surgeons, August 15, 2005. Accessed April 21, 2019.
Feinstein, A. “Conversion Disorder: Advances in Our Understanding.” CMAJ, May 17, 2011. Accessed April 21, 2019.
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