Conversion and Dissociative Disorders
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Introduction
These terms refer to disorders that were until recently known as hysteria. Physical and mental symptoms occur without physical pathology and psychological causation may be demonstrable at least on follow-up.
Symptoms
- Symptoms are produced unconsciously and not deliberately. These symptoms occur primarily as the major feature of conversion or dissociative disorder or secondary to another psychiatric disorder in anxiety, depression or organic mental disorder.
The following strategy has to be resorted while managing a patient of this class:
- Examine the patient thoroughly.
- Reassure the relatives that there is no harm or danger to life.
- Provide opportunity for the patient to talk about the difficulties.
- Early symptom removal has its advantages and disadvantages. Treatment should not be stopped on successful removal of the symptoms. Attempts to resolve the conflicts should be made.
- These patients require active psychological management which may include narcoanalgesia and other specialized techniques which require a specialist’s care.
Treatment
In pressing situations symptomatic treatment with small doses of chlorpromazine (25 mg TID) or diazepam may be needed. Examples of conversion disorder: Pseudo seizure, hysterical hemiplegia, aphonia, blindness, etc.