Conversion disorder
| Classification according to ICD-10 | |
|---|---|
| F44 | Dissociative disorders (conversion disorders) |
| ICD-10 online (WHO version 2019) | |
Conversion disorders are a group of neurotic disorders . In the international classification of mental disorders ICD-10 , they are synonymous with dissociative disorders . Typical symptoms are a loss of identity, memory disorders and a lack of control over body movements. Patients experience neurological symptoms such as numbness , blindness , paralysis , involuntary muscle contractions, or seizures for which no neurological cause can be found. It is currently believed that these problems arise in response to difficulties in the patient's life. In the US classification system DSM-IV , conversion disorder is understood as a somatoform disorder .
Psychoanalysis
Historically, the term conversion comes from the psychoanalysis according to Sigmund Freud . Here it had a wider meaning than it does today. Freud generally referred to the transfer of affects such as fear , aggression , anger , anger , guilt , sexual instinctual wishes, etc. to organs. According to him, not only symptoms such as erectile dysfunction , fainting , headaches or migraines , gastrointestinal disorders, but also general physical reactions such as blushing can be classified as psychosomatic processes of displacement. It is about the displacement of unbearable psychological states on the physical level. A special form of conversion is the affect equivalent , as a defensive reaction of the body, which is felt instead of the triggering emotions.
The process of shifting from the psyche to the soma (body) is seen in psychoanalysis as a defense mechanism . It is supposed to keep unpleasant, unbearable conflicts away from self-awareness. It seems impossible to the unconscious to face the conflict and to deal with it adequately. Conversion is an obvious protective function of the ego that is pathogenic because of the physical suffering it causes .
Discussion of the assignment
Historically, conversion disorders were assigned to hysteria .
Recent research recommends assigning conversion disorders and psychosomatic disorders to the " dissociative disorders ". They then fall into the area of somatoform dissociation and should be summarized under this umbrella term, as a distinction to psychoform dissociation.
Patients with dissociative disorders often suffer from chronic physical complaints, which are to be understood as dissociations. The practitioner should then view the patient's body symptoms as signs of a disintegration of the whole personality.
The symptoms here are presumably the result of an instinctive survival reaction in humans, similar to that of animals, and produce states of excitement or numbness. Looking at the endorphin neurotransmitters on a biochemical level shows a deeper understanding of dissociation on the behavioral level.
study
Doctors and scientists from the Schmieder Clinics (Lurija Institute) , together with colleagues from the University Clinics of Marburg and Magdeburg , examined patients with conversion-related paralysis and healthy individuals who simulated paralysis using magnetic resonance imaging . The authors of the study demonstrated differences in the inhibitory networks of the frontal lobe for motor control in sham simulants and conversion patients . According to the authors, this knowledge of neural correlates provides starting points for the diagnosis and treatment of conversion disorders.
literature
- Ellert RS Nijenhuis: Somatoform dissociation. Phenomena, measurement, and theoretical issues. Van Gorcum, Assen 1999, ISBN 90-232-3527-4 (In German: Somatoforme Dissociation. Phenomena, measurement and theoretical aspects (= series of specialist books on trauma research. ). Junfermann, Paderborn 2006, ISBN 3-87387-623-X ) .
Web links
- Conversion ( memento from June 12, 2013 in the Internet Archive ) on logotherapie.net (PDF file; 106 kB)
Individual evidence
- ↑ WHO: ICD-10 Chapter V, Clinical Diagnostic Guidelines, Geneva 1992.
- ↑ T. Hassa, E. de Jel, O. Tuescher, R. Schmidt, MA Schoenfeld: Functional networks of motor inhibition in conversion disorder patients and feigning subjects. In: NeuroImage. Clinical. Volume 11, 2016, pp. 719–727, doi : 10.1016 / j.nicl.2016.05.009 , PMID 27330971 , PMC 4900693 (free full text).