Diagnosis of DISSOCIATIVE DISORDER F44

Presenting Complaints

• Patients exhibit unusual or dramatic physical symptoms such as seizures, amnesia, trance, loss of sensation, visual disturbances, paralysis, aphonia, identity confusion, "possession" states.

Diagnostic Features

• Physical symptoms that are:
  • unusual in presentation
  • not consistent with know disease
    
    
• Onset is often sudden and related to psychological stress or difficult personal circumstances.
  
  
• In acute cases symptoms may
  • be dramatic and unusual
• severity may change from minute to minute
• symptoms related to attention from others
  
  
• In more chronic cases, patient may look calm, relative to seriousness of complaint.
• Presentation may vary widely in different cultures.

Differential Diagnosis

• Carefully consider medical/physical explanations. A full history and physical (including neurological) examination are essential. Early symptoms of neurological disorders (e.g. multiple sclerosis) can resemble conversion symptoms.
• When other unexplained physical symptoms are present, see section on Unexplained Somatic Complaints.

When pronounced depressive symptoms are present, see section on Depression.

Edited by Gavin Andrews MD, UNSW, Jan 03
© 2003 CRUfAD