Conversion disorder: the modern hysteria

All doctors have encountered patients whose symptoms they cannot explain. These individuals frequently provoke despair and disillusionment. Many doctors make a link between inexplicable physical symptoms and assumed psychiatric ill­ ness. An array of adjectives in medicine apply to symptoms without established organic basis – ‘supratentorial’, ‘psychosomatic’, ‘functional’ – and these are sometimes used without reference to their real meaning. In psychiatry, such symptoms fall under the umbrella of the somatoform disorders, which includes a broad range of diagnoses. Conversion disorder is just one of these. Its meaning is not always well understood and it is often confused with somatisation disorder.† Our aim here is to clarify the notion of a conversion disorder (and the differences between conversion and other somatoform disorders) and to discuss prevalence, aetiology, management and prognosis.