An Introduction to Conversion Disorder and Somatoform Disorders

Though conversion disorder and other somatoform disorders are not as widely talked about in our culture as other mental illnesses such as depression or anorexia - this may not necessarily be due to the fact that it is not common, but because many times it goes undiagnosed. This can occur for a variety of reasons, stretching from stigma attached to psychological evaluations to the discrepancies that arise with the symptoms of conversion disorder and other somatoform disorders.

According to the current version of the Diagnostic Statistical Manual (DSM-IV) as presented on the website for the development of the DSM-V by the American Psychological Association, conversion disorder includes the following symptoms (reworded in places for easier understanding):

• A symptom or "deficit" that affects any voluntary motor (physical movement) or sensory function that would indicate either a neurological (read: brain and nerve related) or other general medical condition.
• The symptom has to be deemed associated with a psychological factor because the symptom started or got worse after conflicts or stressors occurred.
• The symptom or deficit cannot be intentionally produced, faked, or feigned (this would be considered Factitious Disorder or Malingering).
• The symptom or deficit cannot be (after proper investigation) explained by a general medical condition, the effect of a substance (drugs, alcohol, prescriptions, or other substances), or a culturally sanctioned behavior or experience.
• The symptom or deficit must cause a clinically significant problem, or hinder important areas of functioning-such as social or work-related, or is cause for medical evaluation or testing.
• The symptom or deficit is not limited to pain or sexual dysfunction, does not happen only during the course of Somatization Disorder, and cant be better explained by another mental disorder.

Though these are the current requirements to be diagnosed with Conversion Disorder, the up-coming issue of the DSM-V has some proposed changes. I'll spare the proposed changes here, but they can be found at the DSM's website.

Somatoform Disorders are a larger category of disorders, under which Conversion Disorder is included. The classification of Somatoform Disorders is also being reworked currently, but generally all have somewhat similar symptoms-those being somatic symptoms (physical conditions that arise from psychological factors) and cognitive distortions (thought and sensory processes being disrupted). All must be attributed to psychological factors, significantly hindering to functioning, and none can be due to substance abuse, faked, intentionally produced, or feigned. Though they could be reclassified in the next issue of the DSM, there are currently eight different Somatoform Disorders in the DSM-IV.

1. Conversion Disorder: Total list of symptoms is presented above, however can be briefly described as a disorder requiring a person to have a symptom or issue physical in nature with no physical (read: medical), cultural, or substance-abusive reasoning.

2. Body Dysmorphic Disorder: A person is obsessive about flaws in physical appearance that are slight or not really observable to other people. It has to cause a significant clinical problem, and interfere with functioning, and are not restricted to the symptoms present in an eating disorder. This also includes Muscle Dysmorphic Disorder (which emphasizes the body not being toned or muscular enough as the primary "flaw" in their appearance).

3. Undifferentiated Somatoform Disorder: Is a Somatoform Disorder with the same basic symptoms of all of them, and includes two physical problems that cannot be medically explained, or are excessive for what is generally considered to be typical for that medical issue. The problem must persist for at least six months.

4. Somatization Disorder: Is very similar to Undifferentiated Somatoform Disorder, except that it is more specific. Somatization Disorder requires the person have: physical complaints over several years under the age of 30, pain symptoms in at least four different places or functions, two gastrointestinal symptoms (stomach or digestion related), one sexual symptom, and one pseudoneurological symptom (a variety of sensory issues, dizziness, amnesia, seizures, paralysis, or many others).

5. Pain Disorder Associated with Psychological Factors: The onset, severity, or faster onset of pain is judged to be influenced primarily by psychological factors. It is categorized as acute if for less than six months, and chronic if longer than six months.

6. Hypochondriasis: A person believes they have a serious illness, and are incredibly preoccupied with this idea despite the fact that it has been medically proven otherwise, usually perpetuated by misinterpreting bodily symptoms. Has to last at least six months.

7. Pain Disorder Associated with Both Psychological Factors and a General Medical Condition: This disorder accounts for both psychological factors and general medical conditions having generally equal roles in the onset, perpetuation, and severity of the pain.

8. Somatoform Disorder Not Otherwise Specified: This is basically the catch-all for any Somatoform Disorder that doesn't fit the guidelines of the others.

As previously stated, the DSM-V may bring changes with it. For now, however, these are the classifications. If you would like to know more about Conversion Disorder, or other Somatoform Disorders, I would suggest visiting the website of the DSM and American Psychological Association: http://www.dsm5.org .

References:

All information presented in this article was reworded, quoted, or adapted from the DSM-IV, presented on the American Psychological Association's website for the development of the DSM-V: http://www.dsm5.org.