differential diagnosis

Last reviewed 01/2018

• patients with conversion disorder may present with many conditions e.g.blindness, deafness, pseudo seizures, dystonia, paralysis, syncope, or other neurological symptoms
  • presenting symptoms depend on:
    • the cultural milieu, the patient's degree of medical knowledge (i.e., individuals with a high degree of medical knowledge tend to have more subtle symptoms and deficits that may closely simulate neurological or other general medical conditions, whereas those with less medical knowledge may have more implausible symptoms)
    • the underlying psychiatric issue(s)
      
      
• hypochondriasis
  • hypochondriasis is the excessive preoccupancy or worry about having one (or more) serious physical illnesses
    • is the result of an inaccurate perception of the condition of body or mind despite the absence of an actual medical condition (e.g., "I know I've got cancer; they just haven’t done the right test yet")
      
      
• factitious disorder
  • factitious disorder is a condition in which a person acts as if he or she has a physical or mental illness when he or she is not really sick.
    • factitious disorder by proxy is when a person acts as if a person in his or her care has an illness when the person does not
  • this disorder is considered a mental illness because it is associated with severe emotional difficulties
    • patients with factitious disorder deliberately create or exaggerate symptoms of an illness in several ways
      • may lie about or fake symptoms, hurt themselves to bring on symptoms, or alter tests (such as contaminating a urine sample) to make it look like they or the person in their care is sick
  • have an inner need to be seen as ill or injured without the need to achieve personal or financial gain
    
    
• somatisation
  • condition in which a person experiences physical symptoms that are inconsistent with or cannot be fully explained by any underlying general medical or neurological condition
  • patient is distressed because of excessive preoccupation with these symptoms
    
    
• malingering
  • not a mental disorder
  • defined as intentionally feigning the symptoms of a physical, psychiatric, or neurological disorder in order to achieve personal or financial gain
  • individual is fully aware that he or she is feigning the symptoms and has clear knowledge of why he or she is doing it (e.g., for financial gain, recognition, or revenge)

Reference:

• Ali S et al. Conversion Disorder- Mind versus Body: A Review.Innov Clin Neurosci. 2015 May-Jun;12(5-6):27-33.
• Dallocchio C, Marangi A, Tinazzi M. Functional or psychogenic movement disorders: an endless enigmatic tale. Front Neurol. 2015 Feb 27;6:37.