title: [Conversion disorder in an internal medicine department: A series of 37 cases].
abstract: OBJECTIVE
  To describe the clinical characteristics of a series of patients presenting conversion disorder in a general internal medicine ward and outpatient clinic, the arguments retained by the physicians in favour of the diagnosis, the somatic and psychiatric co-morbidities, the management and the outcome of the disorder.
  
  
  METHODS
  We report the study of 37 patients diagnosed with conversion disorder in an internal medicine department of a French university hospital over a period of 14 years. We retrospectively reviewed the charts of the patients and contacted their primary care physicians to obtain follow-up data. No structured instrument was used for the diagnosis of conversion disorder or for the assessment of psychiatric comorbidities.
  
  
  RESULTS
  As expected, patients were mostly young females, although a great variety of age, gender, and socio-cultural background was observed. Motor symptoms predominated (62%). A relevant psychogenic factor was explicitly mentioned in only 43% of the cases. In many cases, organic disease was also present, and an organic cause for the symptom initially considered as conversion was suspected in 3 cases. Depressive and anxious disorders were present respectively in 38% and 35% of cases. A pain complaint was associated in half of the cases. Among patients for whom follow-up data is available, conversion symptoms persisted or recurred in 70% of cases and were associated with a poor quality of life.
  
  
  CONCLUSIONS
  This case series confirms that the DSM-IV-TR criterion of "psychogenicity" (later abandoned in DSM-5) is highly problematic in clinical practice. It suggests a close relationship between conversion disorder and unexplained chronic pain.
authors.affiliation: Service de médecine interne, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors.forename: P
authors.initials: P
authors.lastname: Régny
authors.affiliation: Service de médecine interne, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France. Electronic address: pascal.cathebras@chu-st-etienne.fr.
authors.forename: P
authors.initials: P
authors.lastname: Cathébras
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology; D003291:Conversion Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006748:Hospital Departments; D006785:Hospitals, University; D006801:Humans; D007297:Inpatients; D007388:Internal Medicine; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D010045:Outpatients; D010820:Physicians; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Conversion; Conversion disorder; Douleur chronique psychogène; Functional neurologic disorder; Hysteria; Hystérie; Médecine psychosomatique; Psychogenic chronic pain; Psychosomatic medicine; Somatoform disorders; Trouble neurologique fonctionnel; Troubles somatoformes