The neuropsychiatry of conversion disorder

During the past two decades there has been a relative surge of interest in conversion disorder, and a multitude of studies have emerged on the subject. With continuing developments in neuroscience--mainly brain imaging--new applications to conversion disorder are being reported every year.

Diagnosis continues to represent a challenge, although neurological signs are increasingly being developed and validated to assist with this. Psychiatric co-morbidity diagnosed according to operational criteria is common. Brain imaging studies have brought some clues to understanding the pathophysiology of conversion disorder.

Evidence-based medicine requires reliable diagnostic criteria, and attempts have recently been made to validate some of the well known neurological signs of conversion disorder. From a psychiatric point of view, there is a need for greater understanding of the aetiology and mechanisms underlying conversion disorder and its relationship to other psychiatric disorders. Although advances have been made both in diagnostic methods and in the groundwork for a neurobiological model, no clear rationale for treatment is yet available and further research is strongly needed.