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Tests and diagnosis
By Mayo Clinic staffTo be diagnosed with conversion disorder, you must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
For you to be diagnosed with conversion disorder:
- You must have one or more symptoms you can't control that affect movement of part of your body or your senses. These symptoms must seem as if they could be caused by a neurological or other medical condition.
- Your symptoms must have occurred after a stressful event.
- You're not producing symptoms on purpose.
- Your symptoms aren't fully explained by a general medical condition, drug use or a culturally accepted behavior, such as experiencing visions at a religious ritual.
- Your symptoms must cause significant stress or difficulty in social, work or other settings.
- Your symptoms aren't limited to pain or sexual problems, and aren't better accounted for by another mental health problem.
There are no standard tests to check for conversion disorder. The tests your doctor uses will depend on what kind of signs and symptoms you have. They may include:
- Simple bedside tests. Your doctor checks for normal reflexes to help rule out a physical cause for your signs and symptoms. These tests don't require any specialized equipment and are quick and painless. The exact tests your doctor does depends on your signs and symptoms.
- X-rays or other imaging tests. These tests may help your doctor confirm that your symptoms aren't caused by an injury or neurological or other physical conditions that might cause similar symptoms.
- An electroencephalogram (EEG) scan. Your doctor uses an EEG because it can help rule out a neurological cause of seizure symptoms. This test is a painless procedure to detect electrical activity in your brain. It's used to test for epilepsy and other brain disorders.
Diagnosis can be tricky because a doctor must rule out medical conditions with a physical cause. Conversion disorder can mimic a number of other health problems, including:
- Myasthenia gravis — a muscle weakness disorder
- Guillain-Barre syndrome — an uncommon disorder in which your body's immune system attacks your nerves
- Neurological disorders, such as multiple sclerosis, Parkinson's disease and epilepsy
- Stroke
- Lupus
- Spinal cord injury
- HIV/AIDS
- Conversion disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Nov. 3, 2010.
- Yutzy SH, et al. Conversion disorder. Skodol AE, et al. Specific personality disorders. In: Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Washington, D.C.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.com/resourceToc.aspx?resourceID=5. Accessed Nov. 3, 2010.
- Compton K. Conversion disorder. In: Ferri FF. Ferri's Clinical Advisor 2011. St. Louis, Mo.: Mosby; 2010. http://www.mdconsult.com/books/page.do?sid=1078203392&eid=4-u1.0-B978-0-323-05610-6..00012-3--sc0215&isbn=978-0-323-05610-6&type=bookPage§ionEid=4-u1.0-B978-0-323-05610-6..00012-3--sc0215&uniqId=225194068-16. Accessed Nov. 3, 2010.
- Chastan N, et al. Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation. Movement Disorders. 2010;25:1501.
- Conversion disorder. In: Gabbard GO, ed. Textbook of Psychotherapeutic Treatments. 4th ed.Washington, D.C.: American Psychiatric Publishing; 2009. http://www.psychiatryonline.com/resourceToc.aspx?resourceID=31. Accessed Nov. 3, 2010.
- Hall-Flavin DF (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 3, 2010.
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