n Journal of Depression and Anxiety - Primary psychiatric disorders in patients with conversion reactions : research article

Volume 4, Issue 4
  • ISSN : 1560-0181



A retrospective study of patients with classic conversion symptoms was undertaken to determine if underlying primary psychiatric disorders could be identified. There were 53 patients, 40 females and 13 males age 17 to 67 years (mean =36 years). All patients presented with sensorimotor disturbances or seizures for which no organic etiology could be determined. Stable neurologic deficits or seizures had been present for 6 months or more in all but 6 patients. All patients underwent detailed neurological examination, a semistructured mental status examination and a battery of neurodiagnostic investigations. The mental state of 41 patients admitted to hospital was further explored by daily onetoone interviews, narcoanalysis and art therapy. Psychiatric diagnoses were made from the initial and uncovered psychopathology using DSMIHR criteria. Forty two patients (79%) had depression. Eighty three per cent of these met criteria for major depressive episode. Five (9%) had no depressive symptoms but had other psychiatric disorders. In the remaining 6 (11%) no primary psychiatric disorder could be identified. However, in this group, only one patient had no secondary gain and was adequately studied. Therefore, in patients in whom there was no secondary gain and who were adequately studied, an underlying psychiatric disorder was identified in 47 out of 48 patients (98%).

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