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6.6: Conversion Disorder and Other Somatic Symptom Disorders

  • Page ID
    221691
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    Learning Objectives
    • Describe conversion disorder
    • Describe factitious disorder and factitious disorder imposed on another

    Conversion Disorder

    Conversion disorder, also known as functional neurological symptom disorder, is a type of somatic disorder that is sometimes applied to patients who present with neurological symptoms, such as numbness, blindness, paralysis, or fits, which are not consistent with a well-established organic cause. The symptoms cause significant distress and can be traced back to a psychological trigger. It is thought that these symptoms arise in response to stressful situations affecting a patient’s mental health or an ongoing mental health condition such as depression.

    Older man covering his face with one hand, looking upset.
    Figure \(\PageIndex{1}\): Conversion disorder occurs when physical symptoms result from psychological triggers.

    Conversion disorder begins with some stressor, trauma, or psychological distress. Usually, the physical symptoms of the syndrome affect the senses or movement. Common symptoms of conversion disorder include blindness, partial or total paralysis, inability to speak, deafness, numbness, difficulty swallowing, incontinence, balance problems, seizures, tremors, and difficulty walking. These symptoms are attributed to conversion disorder when a medical explanation for the afflictions cannot be found. Symptoms of conversion disorder usually occur suddenly. Conversion disorder is typically seen in individuals aged 10 to 35 and affects between 0.011% and 0.5% of the general population.

    Conversion disorder can present with motor or sensory symptoms including any of the following:

    • motor symptoms or deficits:
      • impaired coordination or balance
      • weakness/paralysis of a limb or the entire body (hysterical paralysis or motor conversion disorders)
      • impairment or loss of speech (hysterical aphonia)
      • difficulty swallowing (dysphagia) or a sensation of a lump in the throat
      • urinary retention
      • psychogenic non-epileptic seizures or convulsions
      • persistent dystonia
      • tremor, myoclonus or other movement disorders
      • gait problems (astasia-abasia)
      • loss of consciousness (fainting)
    • sensory symptoms or deficits:
      • impaired vision (hysterical blindness), double vision
      • impaired hearing (deafness)
      • loss or disturbance of touch or pain sensation
    Key Takeaways: Conversion Disorder
    Query \(\PageIndex{1}\)

    Factitious Disorder

    A factitious disorder (FD) is a condition in which a person, without a malingering motive, acts as if they have an illness by deliberately producing, feigning, or exaggerating symptoms purely to attain (for themselves or for another) a patient’s role. Individuals with a factitious disorder may produce symptoms by contaminating urine samples, taking hallucinogens, injecting fecal material to produce abscesses, and similar behavior.

    Factitious disorder imposed on self (also called Munchausen syndrome) was for some time the umbrella term for all such disorders. Factitious disorder imposed on another (also called Munchausen syndrome by proxy, Munchausen by proxy, or factitious disorder by proxy) is a condition in which a person deliberately produces, feigns, or exaggerates the symptoms of someone in their care. In either case, the perpetrator’s motive is to perpetrate factitious disorders, either as a patient or by proxy as a caregiver, in order to attain (for themselves or for another) a patient’s role. Malingering differs fundamentally from factitious disorders in that the malingerer simulates illness intending to obtain a material benefit or avoid an obligation or responsibility. For example, a person who is malingering may fake illness to obtain donations from others, or may fake an injury to get disability payments. Somatic symptom disorders, though also diagnoses of exclusion, are characterized by physical complaints that are not produced intentionally.

    Key Takeaways: Factitious Disorder
    Query \(\PageIndex{1}\)
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    Glossary

    conversion disorder (functional neurological symptom disorder): a type of somatic disorder that is sometimes applied to patients who present with neurological symptoms which are not otherwise explained by a well-established organic cause, and often can be traced back to a psychological trigger

    factitious disorder (FD): a condition in which a person, without a malingering motive, acts as if they have an illness by deliberately producing, feigning, or exaggerating symptoms, purely to attain (for themselves or for another) a patient’s role; presents in two ways: factitious disorder imposed on self occurs when someone feigns illness so they experience being the patient, or by others (factitious disorder imposed on another)

    factitious disorder imposed on another: also known as Munchausen by proxy, this is a condition in which a person deliberately produces, feigns, or exaggerates the symptoms of someone in their care

    malingering: a person simulates illness intending to obtain a material benefit or avoid an obligation or responsibility. 

     

    1. Jaghab, K., Skodnek, K. B., & Padder, T. A. (2006). Munchausen's Syndrome and Other Factitious Disorders in Children: Case Series and Literature Review. Psychiatry (Edgmont (Pa. : Township)), 3(3), 46–55.
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    • Modification, adaptation, and original content. Authored by: Christina Hicks for Lumen Learning. Provided by: Lumen Learning. License: CC BY: Attribution
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