Trends in Clinical and Medical Sciences

Socio-demographic factors and pattern of stressor in patients with conversion disorder

Amit Kumar Gupta\(^{1}\), Mohit Saini\(^{2}\), Th. Bihari Singh\(^{3}\) and Mayank Rai\(^{4,*}\)
\(^{1}\) Department of Psychiatry, Government Medical College, Ambedkar Nagar, Uttar Pradesh, India.
\(^{2}\) Department of Psychiatry, Veer Chandra Singh Garhwali Government Institute of Medical Sciences and Research, Srinagar, Uttarakhand, India.
\(^{3}\) Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, India.
\(^{4}\) Department of Psychiatry, Dr. KKBM Subharti Hospital, Dehradun, India.
Correspondence should be addressed to Mayank Rai at rai.mayank0@gmail.com

Abstract

Background: Conversion disorder is a prevalent psychiatric illness characterized by various clinical patterns, including visual paralysis, dystonia, psychogenic non-epileptic seizures, anesthesia-like symptoms, swallowing problems, motor tics, and difficulty walking. These symptoms vary greatly from case to case and can vary in the same patient during successive episodes. Most symptoms are related to life stressors.
Study design: A cross-sectional study was conducted to estimate the sociodemographic profile, types of stressors, and variety of clinical symptoms presented in patients with conversion disorder in a tertiary care center in the North-East region of India. A total of 74 patients diagnosed according to Diagnostic and Statistical Manual of Mental Disorders Fifth Edition criteria were included. Patients underwent assessments of comorbidity using the Hamilton Depression Rating Scale, Hamilton Anxiety Scale, and assessments of stressful life events using the Presumptive Stressful Life Event Scale.
Result: The most common lifetime stressor was excessive alcohol use by family members with financial loss or problems (43.7%). Immediate stressors prior to the onset of illness were broken engagement or love affair (25.7%), family conflict (24.3%), marital conflict (14.9%), examination-related problems (10.8%), and other problems (23%). Motor symptoms were the most common type of clinical presentation (58.4%), with pseudo-seizures being the most common (29.7%). Other motor symptoms included paresis of the lower limb (9%), paresis of the left-side upper and lower limb (2.7%), aphonia/dysphonia (12.2%), limb paralysis (1.4%), dysphasia (2%), and ataxia (1.4%). Conversion disorder with mixed motor and sensory deficit (multiple fainting spells) was found to be the most common symptom (37.8%) in this region.

Keywords:

Conversion disorder; Stress; Anxiety; Depression.