INTRODUCT
ION
• Somatoform disorder
• A condition where emotion or mental
distress manifests physical symptoms
• Physical response is not under control
• Both the motor and sensory controls
are affected
• May result in paralysis of limbs and
tremors
• Many a times it gets difficult to
diagnose the problem as physical
distress or mental distress
DEFINITION
Conversion disorder is
characterised by the presence of
one or more symptoms
suggesting a neurological
disorder that cannot be explained
by any known neurological or
medical disorder but is often
associated with stress or conflict
CHARACTERISTICS
• Physical symptoms are generally unintentional
• Primary gain- The produced symptoms reduce
anxiety of the patient by keeping psychological
conflict out of conscious awareness
• Secondary gain- It is in the form of Sympathy and
attention that is mostly advantageous to the patients
• La belle indifference- The patient shows less distress
or show lackof concern about the symptoms
• Physical examination and investigation don't reveal
any medical or neurological abnormalities
• It includes motor deficit, sensory deficit, seizures,
convulsions, mixed presentations
ETIOLOGY
Genetical factors- Hysteria or conversion
disorder in families
Psychological factors- Ineffective coping
mechanism, developmental regression,low
intelligence, anxiety, depression
Family dynamics- Relationship between the
family member, conflicts between parents
Social factors- Relationship among friends or
social groups, environment of society
Economical factors- Poverty, unemployment
• Other factors- Lack of situational support,
sexual or physical abuse in childhood,
traumatic events
PSYCOPATHOLOGY
RISK
FACTORS
Recent significant stress or emotional trauma
Being female
Being an adolescent or young adult
Having a mental health condition, such as mood and anxiety
disorders, dissociative disorder and certain personality disorders
Having a family member with conversion disorder
• Financial problems
• Substance abuse
SYMPTOMS
Psychogenic nonepileptic seizures
Paralysis or weakness of limbs
Collapsing weakness
Abnormal movement
Tremor
Functional gait disorder
Dystonia
Myoclonus
Anesthesia or sensory loss
Visual disturbances
Olfactory or hearing disturbances
Speech disturbance
• Swallowing disturbance
PHARMACOLOGICAL TREATMENT
Sedatives like Inj.
Phenobarbitone
Antianxiety drugs like
chloropromazine
Antidepressant drugs like
imipramine
• SSRI’s like fluoxetine
NON-PHARMACOLOGICAL
TREATMENT
• Psychotherapy- Cognitive
behavioural therapy, individual
psychotherapy, group therapy
• Hypnosis
• Trans cranial magnetic
stimulation
• Rehabilitation therapy
• Relaxation therapy
• Stress reduction or distraction
technique
• Physical therapy
NURSING DIAGNOSIS
Ineffective coping skills related to unresolved
psychological conflicts
Anxiety related to extreme concern about physical
illness/symptoms
Low self-esteem related to perceived threat to
perform daily functional activities
Powerlessness related to perceived lack of ability
to improve the physical health
Social isolation related to lack of ability to
participate in social events
• Interrupted family process related to the
assumption of sick role
NURSING INTERVENTIONS
Review the patient’s Obtain a medical & psychological history
Introduce yourself to the patient and provide one-on-one
interaction for the patient
Confirm the patient’s identity and relate a sense of acceptance
to the patient
Explain procedures or interventions to the patient and family
Assess vital signs, height, weight and functional abilities.
Identify for secondary gains from the symptoms
Identify patient’s ability to communicate
Review medications taken by the patient
Alleviate patient’s symptoms, if possible
Consult with occupational & physical therapist
• Provide positive reinforcement for goals obtained
