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Conversion disorder
Subject : Mental health nursing
Group no : 07 ”
Group members
♥ Wasil Ahmad (group leader)
♥ Dildar Muhammad
♥ Malik.M. Abubakar
♥ Khalil ullah
♥ Naseer Ud Din Abbasi
♥ Rashid Ali
♥ Khawar Hayat
♥ Arif Ullah
♥ Ihsan Ullah
♥ Muhammad Alyan
Objectives :
By the end of the session participants will be able to:
Define conversion disorder
Describe the types of conversion disorder
Enlist the signs and symptoms
Discuss the causes / Etiology
Describe the risk factors
Discuss the complications
Identify the diagnostic test
Explore the medical management
Discuss the nursing management
Introduction
Conversion disorder is a condition where a mental health issue disrupts
how your brain works. This causes real, physical symptoms that a person
can’t control. Symptoms can include seizures, weakness or paralysis, or
reduced input from one or more senses (sight, sound, etc.). This condition
is often treatable through various types of therapy.
Definition
What is conversion disorder?
Functional neurological symptom disorder — better known as “conversion
disorder” — is a mental health condition that causes physical symptoms. The
symptoms happen because your brain “converts” the effects of a mental health
issue into disruptions of your brain or nervous system.
OR
Conversion disorder (also known as functional neurological system disorder) is a
condition in which a person experiences physical and sensory problems, such as
paralysis, numbness, blindness, deafness or seizures, with no underlying neurologic
pathology. These problems are serious enough to negatively impact important life
functions, such as academic performance, social relationships and family life.
Types of conversion disorder
Conversion disorder has been categorized into four subtypes:
1) With motor deficits (symptoms).
2) With sensory deficits (symptoms).
3) With pseudo seizures.
4) With mixed symptoms.
Who does it affect?

Conversion disorder can affect people throughout their life, including

during childhood. Certain symptoms are more likely at different ages.
Conversion disorder is also much more likely to happen in women and
those designated female at birth (DFAB). Available research shows at
least twice as many women have conversion disorder compared to men
or people designated male at birth (DMAB).
Statistics
How common is conversion disorder?
Conversion disorder isn’t a common problem. Experts estimate that 4 to 12
people out of every 100,000 receive a diagnosis of conversion disorder
each year.
 Signs and Symptoms
The symptoms of conversion disorder can vary widely depending on the part of the brain
involved. Some of the most common symptoms include:
 Psychogenic non-epileptic seizures (PNES):
(the word “psychogenic” means “of mental health origin”).
Seizures typically happen because of conditions or issues with your brain’s structure or how
it’s working. Psychogenic non-epileptic seizures happen because of mental health conditions.
 Sense-related disruptions:
Trouble with senses of vision, hearing, smell, taste and touch are all possible with conversion
disorder. Some examples include double or tunnel vision, hearing loss or numbness, and the
inability to feel something touching your skin.
Cont…
 Pain: People with conversion disorder often feel pain, sometimes with other symptoms
and sometimes on its own.
 Unusual muscle tension, spasms, twitches and tremors. These all happen because of a
disruption in how your brain controls your muscles.
 Muscle weakness or paralysis.
 Trouble swallowing (dysphagia).
 Dizziness.
 Fainting or passing out (syncope).
 Chronic fatigue or lack of energy.
Etiology / Causes
Experts don’t know exactly why conversion disorder happens. However, they do
know that it’s more likely to happen along with certain circumstances and some
medical conditions.
Common circumstances seen in people with conversion disorder include:
 A history of childhood abuse.
 Having other mental health conditions, especially depression or anxiety.
 A recent stressful or traumatic event.
 A recent health condition or event acting as a trigger for conversion disorder.
Risk factors
Factors that may increase your risk of functional neurologic disorder include:
 Having a neurological disease or disorder, such as epilepsy, migraines or a movement
disorder.
 Recent significant stress or emotional or physical trauma.
 Having a mental health condition, such as a mood or anxiety disorder, dissociative disorder
or certain personality disorders.
 Having a family member with a neurological condition or symptoms.
 Having a history of physical or sexual abuse or neglect in childhood.
 Females may be more likely than males to develop functional neurologic disorder.
Complications
Some symptoms of functional neurologic disorder, particularly if not treated, can result in
substantial disability and poor quality of life, similar to problems caused by medical
conditions or disease.
Functional neurologic disorder may be associated with:
 Pain
 Anxiety disorders, including panic disorder
 Depression
 Insomnia
 Fatigue
Diagnostic evaluation
 Patient history
 Physical examination
 Neurological examination
 Diagnostic test / imaging scans
What tests will be done to diagnose this condition?
 Computerized tomography (CT) scan.
 Electroencephalogram (EEG).
 Electromyogram.
 Evoked potentials test.
 Magnetic resonance imaging (MRI).
Treatment / Medical Management
Conversion disorder is a mental health condition that causes physical symptoms.
Because of that, treating the mental health component with some form of
psychotherapy (mental health therapy) is usually the first approach. It’s also usually
the most successful approach . The most common types of psychotherapy include:
 Cognitive behavioral therapy (CBT): This is the most common type of therapy
recommended. Experts also consider it the most likely to work.
 Hypnotherapy: This is usually a second option for types of therapy. It may be
especially helpful when the symptoms of conversion disorder affect your ability to
speak or any of your senses.
Cont…
 Group or family therapy: Shared therapy experiences can help people with
conversion disorder. Group therapy can help people with this condition
connect with others who have similar struggles. Family therapy can help
loved ones understand the condition and offer support.
Other treatments that may help include:
 Physical therapy: The symptoms of conversion disorder may start with
mental health, but the physical effects are still real. Physical therapy can help
people with conversion disorder recover from or adapt to the physical
symptoms.
Cont…
 Medication: When conversion disorder happens alongside other conditions, such as
depression or anxiety, medications for those conditions can help conversion disorder
symptoms also. This is especially true when conversion disorder causes pain symptoms,
as antidepressants can often positively affect pain levels.
 Biofeedback: Biofeedback is an alternative medicine approach that teaches people to
change the way their bodies function. It’s a mind-body therapy that may improve your
physical and mental health. During a biofeedback session, your provider uses
monitoring equipment and instruments to measure your body’s functions. Based on
feedback from the instruments, your provider suggests how you can create physiologic
changes. With education and practice, you can learn to make those bodily changes
without equipment.
Nursing Management
Nursing Assessment
The nurse must investigate physical health status thoroughly to
ensure there is no underlying pathology requiring treatment.
 History.
 General appearance and motor behavior
 Mood and affect
 Thought process and content
Cont…
Nursing Diagnosis
 Chronic pain related to severe level of anxiety, repressed.
 Ineffective coping related to inadequate coping skills.
 Self-care deficit related to paralysis of body part, pain, discomfort.
 Deficient knowledge related to lack of interest in learning, severe anxiety.
Cont…
Nursing Interventions
 Providing health teaching. The nurse must help the client establish a daily routine
that includes improved health behaviors.
 Assisting the client to express emotions. Clients may keep a detailed journal of their
physical symptoms; the nurse might ask them to describe the situation at the time such
as whether they were alone or with others, whether any disagreements were occurring,
and so forth.
 Teaching coping strategies. Emotion-focused strategies include progressive
relaxation, deep breathing, guided imagery, and distractions such as music or other
activities; problem-focused coping strategies include problem-solving methods,
applying the process to identified problems, and role-playing interactions with others.
Summary
Conversion disorder, or functional neurological symptom disorder, is a condition where
individuals experience neurologic symptoms that no underlying pathology can explain.
Conversion disorder is often associated with stressful life events and other comorbid mental
health disorders, including certain personality traits, anxiety, depression, or substance use
disorders. Diagnosis of conversion disorder is based on clinical presentation, a thorough
physician exam, and tests to rule out other causes of the symptoms. Treatment usually consists
of empathy by the healthcare provider, psychotherapy, and antidepressant medications, in cases
where individuals have comorbid mental health disorders or feel hindered by their disorder.
Multiple choice questions (MCQs)
1.In patients with conversion disorder, physical symptoms similar to those of a
nervous system (neurologic) disorder develop, but the origin is emotional rather
than physical. Which of the following is NOT a correct statement about
symptoms of conversion disorder?
a) The person may complain that an arm or a leg has become paralyzed
b) Symptoms begin after some distressing event
c) Symptoms may resemble a seizure disorder
d) The person intentionally causes the symptoms
Answer :D

2. Which of the following is essential to the successful treatment of a patient

with conversion disorder?
e) A supportive, trusting doctor-patient relationship
f) Cognitive-behavioral therapy
g) Psychotherapy
h) Use of hypnosis to help the person control the mental effects of stress
Answer :A
Cont…
3.Which of the following is a basic feature of Conversion Disorder?
a) Symptoms or deficits affecting voluntary motor or sensory function suggestive of an
underlying or neurological condition.
b) These symptoms must cause the individual significant distress
c) Impair social , occupational or other functioning
d) All of the above
Answer :D

4.Before conversion disorder was included in the DSM, it popularly known in

psychodynamic circles as what?
e) Hysteria
f) Histrionics
g) Mental paralysis
h) Repression
Answer :A
Cont…
5.Which of the following is not a common motor symptom in Conversion Disorder?
a) Paralysis
b) Impaired balance
c) Urinary retention
d) Double vision
Answer :D

Subjective question :
Q1:what is conversion disorder and also enlist the signs/symptoms of conversion disorder?
References :
https://my.clevelandclinic.org/com

https://www.chop.edu/com

https://www.mayoclinic.org/com

https://www.ncbi.nlm.nih.gov/com

https://nurseslabs.com

https://www.msdmanuals.com

https://www.blackwellpublishing.com
Any Question
Thank you
For your special attentions