4th Pediatric Infectious Diseases Conference
 
 
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Hysteria(Conversion Disorders) in Children
CONVERSION DISORDERS (HYSTERIA)
Q. What is conversion disorder?
A. Conversion disorder or Hysteria is a disorder whereby a person expresses emotional turmoil by converting it into a bodily symptom. It is now called as PSYCHOLOGICAL FACTORS AFFECTING MEDICAL CONDITIONS. The term "hysteria" is no longer used.


Q. How does a patient with hysteria present?
A. Hysteria may present as affliction of organ of special senses i.e. as hysterical deafness, hysterical blindness. It may also affect the voluntary nervous system and patient may present with hyperventilation, convulsions, paraesthesias etc.

Q. A patient has come with inability to walk suddenly. How do I know whether the patient actually has a problem?
A. There are two ways to diagnose a conversion disorders: -

conversion disorder diagnosis Positive diagnosis whereby a temporal relationship between psychological     stress and onset of symptoms is established. Associated features established     are those of elicitable gain. The patient has dramatic symptoms without     associated physical signs.
conversion disorder diagnosis Negative diagnosis - The patient has multiple symptoms where the     disability is out of proportion to any elicitable disorder. Conversion disorder is     diagnosed as absence of any physical cause.

Conversion disorders are more common in females. They are often seen in families with unstable relationships. Patients may also have common associated symptoms like :-

conversion disorder diagnosis Multiple hospitalisations for symptoms without signs.
conversion disorder diagnosis Willingness to go through painful investigations.
conversion disorder diagnosis In females, it may be associated with menstrual problems.

During the history taking, you may get a vicarious feeling as if the patient is enjoying the symptoms.


Q. How does hysteria occur?
A. There are two types of hysteria :

Types of Hysteria Conversion disorders whereby the emotional turmoil is expressed      unknowingly as a bodily symptom

Types of Hysteria Dissociative states
     Fugue Fugue
     Amnesia Amnesia
     Dual personality disorders Dual personality disorders - e.g Jekyll & Hyde personality


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