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Hysteria

The document provides an overview of conversion disorder, also known as hysteria, highlighting its characteristics as a somatoform disorder with physical symptoms not intentionally produced. It discusses epidemiology, etiology, clinical features, differential diagnosis, and management strategies, including psychological care and medication. The document emphasizes the importance of effective coping strategies and client safety in treatment evaluation.

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14 views21 pages

Hysteria

The document provides an overview of conversion disorder, also known as hysteria, highlighting its characteristics as a somatoform disorder with physical symptoms not intentionally produced. It discusses epidemiology, etiology, clinical features, differential diagnosis, and management strategies, including psychological care and medication. The document emphasizes the importance of effective coping strategies and client safety in treatment evaluation.

Uploaded by

amirmamman9
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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NURS 302(MENTAL HEALTH

NURSING)

LECTURE NOTES ON CONVERSION

DISORDER/HYSTERIA
SOMATOFORM DISORDERS
Physical symptoms suggest a
physical disorder.
Medical evaluation and diagnostic
tests are negative.
Symptoms are linked to
psychobiological factors.
In contrast to malingering and
factitious disorder, symptoms are not
intentional or under conscious
control
SOMATOFORM DISORDERS
Somatization disorder

Hypochondriasis (misinterpretation of

real physical sensations)


Pain disorder

Body dysmorphic disorder(preoccupation

with an imagined defective body part)


Conversion/dissociation disorder
DIFFERENTIALS
 Malingering

 Intentionally
producing symptoms to
achieve an environmental goal
 Factitious disorder

 Fabrication of symptoms or self-inflicted


injury to assume the sick role
 Psychosomatic illness

A real medical condition affected by


stress or psychological factors
DISSOCIATION (CONVERSION) DISORDER
FORMERLY HYSTERIA

INTRODUCTION
 Disorder of sudden dramatic symptoms
 Inconsistent with known diseases
 “Unconscious” process---not malingering
 Symptoms may present singly or en masse
DISSOCIATION/CONVERSION DEFINED

Disturbances in the normally well-integrated

continuum of consciousness, memory, identity

and perception
EPIDEMIOLOGY
 Incidence reported as 22 per 100,000
 5 to 15 % of psychiatric consultations in
general hospitals
 Ratio of men to women is 1 to 2
 Men mostly involved in occupational and
military accidents
 Common age is adolescents and young
adults
EPIDEMIOLOGY

 Common among rural populations, little edu-

cated persons, those with low IQ, low socioe-

conomic groups and military personnel ex-

posed to combat situations


ETIOLOGY
 Psychoanalytic factors
Conflict between an instinctual impulse and the
prohibitions against its expressions
 Biological factors
Brain imaging shows hypo metabolism of the
dominant hemisphere and hyper metabolism of
the non dominant hemisphere
Excessive cortical arousal
Aetiology continued

 Neuropsychological tests reveal cerebral im-


pairments in verbal communication, memory ,
vigilance , affective incongruity and attention
 Psychological
CLINICAL FEATURES
 Paralysis
 Blindness
 Mutism
SENSORY SYMPTOMS
 Anaesthesia
 Paresthesia
 Stocking and glove anaesthesia of the hands
and feet
 Hemi anaesthesia of the body along the midline
MOTOR SYMPTOMS
 Abnormal movements (jerks)
 Gait disturbance
 Weakness
 Paralysis
SEIZURE SYMPTOMS
 Pseudo seizures are common
Pupillary and gag reflexes are retained after
pseudo seizures
No post seizure increase in prolactin levels
 Co existing epileptic disorder
ASSOCIATIVE FEATURES

 Primary gains

 Secondary gains

Avoiding difficult life situations

Receiving support and assistance

Controlling others’ behaviour


 La belle indifference
DIFFERENTIAL DIAGNOSIS
 Epileptic fit
 Physical conditions causing similar symptoms
 Neurological illnesses esp. multiple
sclerosis,myopathies,early neurological symp-
toms of AIDS
 Atypical depression
 Unexplained somatic complaints
 Anxiety disorders
MANAGEMENT
 Good history taking
 Advice and support to the patient and family
• Symptoms have no clear physical cause
• Can be brought about by stress
• Symptoms usually resolve rapidly leaving no

permanent damage
PSYCHOLOGICAL CARE
 Encourage the patient to acknowledge recent
stresses
 Give positive reinforcement
 Take brief rest from stress before returning to
usual activities
 Advise against prolonged rest or withdrawal
from activities
MEDICATION

 Anxiolytics
 Anti depressants
NURSING DIAGNOSIS

Ineffective coping

disturbed body image

chronic low self-esteem

self-care deficits

pain
Evaluation: Successful Treatment

Conflicts
Client safety
explored
maintained

Effective
Anxiety reduced
use of new coping strategies

Client functions at a higher level

Elsevier items and derived items © 2006 by Els


evier Inc. All rights reserved.
THANK YOU ALL

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