The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) classifies somatoform disorders in the following diagnoses:
somatization disorder, undifferentiated somatoform disorder, somatoform disorder not otherwise specified (NOS), conversion disorder
, pain disorder, body dysmorphic disorder, and hypochondriasis. These disorders all involve clinically significant distress or impairment in daily functioning.
The diagnostic criteria for these somatoform disorders are established for adults, but not many published case studies and research have focused on pediatric populations.
It must be noted that DSM-IV is currently under revision with a proposal to rename the classification to somatic symptom disorders and complex somatic symptom disorders.
Conversion disorder, also called functional neurological symptom disorder, is a condition in which you show psychological stress in physical ways.The condition was so named to describe a health problem that starts as a mental or emotional crisis — a scary or stressful incident of some kind — and converts to a physical problem.
For example, in conversion disorder, your leg may become paralyzed
after you fall from a horse, even though you weren't physically injured. Conversion disorder signs and symptoms appear with no underlying physical cause, and you can't control them.
Signs and symptoms of conversion disorder typically affect your movement or your senses, such as the ability to walk, swallow, see or hear.
Conversion disorder symptoms can vary in severity and may come and go or be persistent. The outcome may be better in younger children than in teenagers and adults. According to some experts, most people get better with immediate and proper management.
Conversion disorder symptoms may appear suddenly after a stressful event or trauma, whether physical or psychological. Signs and symptoms that affect movement function may include:
• Weakness or paralysis
• Abnormal movement, such as tremors or difficulty walking
• Loss of balance
• Difficulty swallowing or "a lump in the throat"
• Seizures or convulsions
• Episode of unresponsiveness
Signs and symptoms that affect the senses may include:
• Numbness or loss of the touch sensation
• Speech problems, such as inability to speak or slurred speech
• Vision problems, such as double vision or blindness
• Hearing problems or deafness
Episodes of conversion disorder are nearly always triggered by a stressful event, an emotional conflict or another mental health disorder, such as depression.
The exact cause of conversion disorder is unknown, but the part of the brain that controls your muscles and senses may be involved. It may be the brain's way of reacting immediately to something that seems like a threat.
Conversion disorder risk factors include:
• Recent significant stress or emotional trauma
• Being female — women are much more likely to develop conversion disorder
• Having a mental health condition, such as mood or anxiety disorders,
dissociative disorder or certain personality disorders
• Having a neurological disease that causes similar symptoms, such as epilepsy
• Having a family member with conversion disorder
• A history of physical or sexual abuse and neglect in childhood
In some cases, particularly if not treated soon enough, conversion disorder symptoms can result in substantial disability, similar to that caused by medical conditions.