Organic syndromes diagnosed as conversion disorder: identification and frequency in a study of 85 patients

J Psychosom Res. 2000 Jul;49(1):7-12. doi: 10.1016/s0022-3999(99)00107-5.


Background: The percentage of patients initially diagnosed with a conversion disorder and later identified as having an organic disorder has been decreasing in recent studies.

Method: Consecutive patients with a diagnosis of conversion disorder were referred for psychiatric diagnosis and treatment. Research questions were: (1) What incidence of neurological disorder is revealed by neurological reassessment and by which diagnostic technique is the final diagnosis established? (2) What differences can be observed between true-positive and the false-positive results?

Results: Ten (11.8%) of the 85 patients examined appeared to suffer from a neurological disorder. In this sample, variables discriminating between the true positives and false positives were: (1) prior suspicion of neurological disorder; (2) older age at referral; (3) older age at onset of symptoms; (4) longer duration of symptoms; and (5) use of medication. Three variables contributed significantly to the prediction of organic disorder: prior suspicion of neurological disorder; age at onset of symptoms; and duration of symptoms.

Conclusions: Although our results are in line with those of other recent studies, the percentage of false positives was still high. The data further emphasize the dangers of making a diagnosis of conversion disorder in the absence of positive evidence. It is important to continue to provide follow up for patients with a diagnosis of conversion disorder. Unfortunately, unreliable psychiatric indications, like certain behavioral characteristics, are still used in the diagnostic process. The results show that a general neurological examination is still a valuable diagnostic instrument in addition to modern diagnostic techniques.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Conversion Disorder / diagnosis*
  • Conversion Disorder / epidemiology
  • Diagnostic Errors
  • Female
  • Hospitals, Psychiatric
  • Humans
  • Male
  • Middle Aged
  • Nervous System Diseases / diagnosis*
  • Nervous System Diseases / epidemiology
  • Netherlands / epidemiology
  • Patient Care Team
  • Referral and Consultation