[Conversion and dissociation: together or separated?]

Tijdschr Psychiatr. 2021;63(6):455-461.
[Article in Dutch]

Abstract

Background: Conversion and dissociation in their relationship have made a lot of pendulum movements over time between moving together and away from each other. In the run-up to the introduction of DSM-5, it was argued that conversion should be classified as a dissociative disorder, but this didn't happen.

Aim: In this article, the clinical scientific evidence is examined for the relationship between conversion and dissociation. We provide an overview of the recent clinical studies that examine both syndromes together. We also investigate the main overlapping predisposing characteristics and psychopathological explanatory models of both syndromes.

Method: Literature review in PubMed and PsycArticles.

Results: Our findings confirm that there is a large comorbidity between conversive and dissociative symptoms in clinical reality. Both syndromes have a high prevalence of reported trauma and emotion dysregulation. However, evidence for present biomarkers is still llimited. The underlying explanation models are applicable for both conversion and dissociation.

Conclusion: We want to draw attention to the plea to bring conversion disorders back together with dissociative disorders. Moreover, the possible presence of trauma, the influential role of psychosocial stressors, the present psychiatric co-morbidity and the style of emotion regulation seem to justify the approach to conversion problems from a biopsychosocial perspective rather than from a purely biomedical perspective.

Publication types

  • Review

MeSH terms

  • Comorbidity
  • Conversion Disorder* / diagnosis
  • Conversion Disorder* / epidemiology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Dissociative Disorders* / diagnosis
  • Dissociative Disorders* / epidemiology
  • Emotions
  • Humans