Childhood trauma, dissociation, and psychiatric comorbidity in patients with conversion disorder

Am J Psychiatry. 2004 Dec;161(12):2271-6. doi: 10.1176/appi.ajp.161.12.2271.


Objective: The aim of this study was to evaluate dissociative disorder and overall psychiatric comorbidity in patients with conversion disorder.

Method: Thirty-eight consecutive patients previously diagnosed with conversion disorder were evaluated in two follow-up interviews. The Structured Clinical Interview for DSM-III-R, the Dissociation Questionnaire, the Somatoform Dissociation Questionnaire, and the Childhood Trauma Questionnaire were administered during the first follow-up interview. The Structured Clinical Interview for DSM-IV Dissociative Disorders was conducted in a separate evaluation.

Results: At least one psychiatric diagnosis was found in 89.5% of the patients during the follow-up evaluation. Undifferentiated somatoform disorder, generalized anxiety disorder, dysthymic disorder, simple phobia, obsessive-compulsive disorder, major depression, and dissociative disorder not otherwise specified were the most prevalent psychiatric disorders. A dissociative disorder was seen in 47.4% of the patients. These patients had dysthymic disorder, major depression, somatization disorder, and borderline personality disorder more frequently than the remaining subjects. They also reported childhood emotional and sexual abuse, physical neglect, self-mutilative behavior, and suicide attempts more frequently.

Conclusions: Comorbid dissociative disorder should alert clinicians for a more chronic and severe psychopathology among patients with conversion disorder.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child Abuse / psychology
  • Child Abuse / statistics & numerical data*
  • Chronic Disease
  • Comorbidity
  • Conversion Disorder / diagnosis*
  • Conversion Disorder / epidemiology
  • Dissociative Disorders / diagnosis*
  • Dissociative Disorders / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Prevalence
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Surveys and Questionnaires