Conversion disorder, dissociation, comorbidity

Conversion disorder (CD) is defined as the emergence and course of one or more symptoms, which are caused by psychological conşicts or needs affecting the voluntary motor or perceptual functions. Although CD can be seen at any time between early childhood to late old ages, it is reported to be most common between the 15-35 years of age. In a general hospital setting 5 to 16% of all psychiatric patients have conversion symptoms. In Turkey, among outpatients who were admitted to a primary health care center, the lifetime prevalence of conversion symptoms was 48.2%. In western societies, the rate of CD is 1-3% in clinical populations whereas in non western societies rate for CD is about 10%. CD is more prevalent among females compared to males with a ratio ranging between 2:1 to10:1. CD is also more prevalent in rural areas, developing countries, low socioeconomic classes, among under educated people and those with relatively low medical knowledge. Conversion disorder is generally accompanied by a neurological or psychiatric disorder. Comorbidities significantly affect the prognosis and the treatment of CD symptoms. The most common psychiatric comorbidities for CD are mood disorders, anxiety disorders, dissociative disorders and somatoform disorders. Personality disorders also accompany CD. The comorbidity of dissociative disorders interferes with the treatment of primary disorder further complicating the prognosis.