The validity of broadly defined hysteria and DSM-III conversion disorder: outcome, family history, and mortality

Area of Science:

• Psychiatry
• Clinical Psychology
• Medical Sociology

Background:

• Patients diagnosed with hysteria often do not meet criteria for Briquet's syndrome (somatization disorder).
• Previous research indicated familial psychopathology similarities between these patients and those with primary depression.
• The diagnostic validity and clinical outcomes of conversion disorder require further investigation.

Purpose of the Study:

• To investigate the familial psychopathology and mortality rates in patients with conversion disorder.
• To compare the outcomes of conversion disorder patients with those diagnosed with Briquet's syndrome.
• To assess the diagnostic heterogeneity within conversion disorder.

Main Methods:

• Retrospective analysis of patient records with chart diagnoses of hysteria.
• Comparison of familial psychopathology and mortality data between diagnostic groups.
• Application of DSM-III criteria for conversion disorder and Briquet's syndrome.

Main Results:

• Patients meeting DSM-III criteria for conversion disorder exhibited excess mortality, mirroring primary depression.
• Outcome and mortality data differentiated conversion disorder from Briquet's syndrome.
• Family history data indicated significant heterogeneity within the conversion disorder diagnosis.

Conclusions:

• Conversion disorder patients share mortality patterns with primary depression, suggesting a distinct clinical entity.
• The current diagnostic criteria for conversion disorder may encompass heterogeneous patient groups.
• The label "conversion disorder" is proposed as a descriptive alternative to "undiagnosed" pending further diagnostic validation.