Sunday, March 26, 2023

Pediatric Conversion Disorder


Conversion disorder is included in a newly defined category in the fifth edition of the American Psychiatric Association’s (APA)Diagnostic and Statistical Manual of Mental Disorders (DSM-5) called Somatic Symptom and Related Disorders.
It first appeared as part of the group of somatoform disorders in the 1980 DSM third edition (DSM-III).

Until the fourth edition (DSM-IV), somatoform disorders were characterized by persistent physical symptoms without an identifiable medical or physiologic explanation and symptoms that were supposed to be linked to psychological factors or conflicts.
However, there was significant overlap across the somatoform disorders and a lack of clarity about their boundaries. Therefore, in DSM-5, several of the diagnoses were removed, replaced, and some renamed. However, conversion disorder remains in the new edition.

Diagnostic criteria were established for adults predominantly, and these criteria generally are extended to children; there are no separate child-specific criteria. Diagnoses in children and adolescents are more difficult because the expression of emotional distress in the form of physical complaints is developmentally appropriate in younger children, who lack the capacity to accurately verbally report symptoms and emotional distress. However, when physical symptoms are persistent and a child’s functioning deteriorates, a somatic symptom disorder can be considered.

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