[Conversion disorder in the elderly]

The dismemberment of the concept of neurosis, particularly of hysteria, in the current classifications (DSM-III and following, ICD-10) has led the authors to consider the concept of somatisation and the various situations included in it. Somatic disorders as the manifestation of a mental disorder, often of a depressive or anxious nature, bring back to the forefront both hysteria and its semiological forms under the global term "somatoform disorders", and in parallel with new pathologies, somatic symptoms as specific behaviors associated with the representation of a morbid condition from the point of view of an inhabitual physical perception. The expression of the psychic apparatus into the body, and its various clinical manifestations, has no direct specificity in the elderly. However, it is both frequent, and frequently misunderstood, thus requiring particular vigilance from the physician when confronted with physical complaints among elderly patients in whom the link between the body and the psychic apparatus takes on a particular role with the approach of death and the bereavement process that it requires. A structural approach, and search for event-driven factors and psychodynamic elements should be the key points of the clinician's approach.