Which option is true regarding the diagnosis of conversion disorder?
A. Can be made reliably if the patient exhibits la belle indifference B. Is more likely in a man than in a woman C. Is more likely in a patient from a high socioeconomic group than from a low one D. Is supported if the patient has sensory complaints rather than motor complaints E. Is supported if the patient is devoid of insight that the symptoms have no organic etiology
Is supported if the patient is devoid of insight that the symptoms have no organic etiology-the answer is e, is supported if the patient is devoid of insight that the symptoms have no organic etiology. conversion disorders usually present with the sudden onset of a single symptom related to a severe stress. they are much more frequent in women and more prevalent in less educated and lower socioeconomic populations. loss of neurologic function is the most typical conversion symptom. motor complaints, usually involving voluntary muscles, are more common than sensory complaints. la belle indifference, the surprising lack of concern by the individual despite the severity of the problem, is often described. however, it is absent in about half of cases and is found just as often in patients with organic disease . therefore, it is no longer considered diagnostic. patients are indeed devoid of insight that the symptoms have no organic etiology the diagnosis of conversion disorder must be made with great caution and only after all organic etiologies are ruled out and the appropriate psychological criteria met. disorders such as lupus, multiple sclerosis, and hyperthyroidism that can present with puzzling symptoms of vague onset are examples of organic disorders that should be kept in mind when excluding other etiologies. various physical examination techniques such as the optokinetic drum for evaluating blindness can be used to help distinguish true neurologic deficits from a conversion disorder. when diagnosed, conversion disorders should be treated by reassuring the patient that no serious medical problem has been found and suggesting that the symptoms will likely resolve. psychiatric evaluation/referral is also necessary.(tintinalli, 1830-1831)