General Considerations | Specific Techniques for Treatment of Conversion Symptoms
There are several steps to be considered in the comprehensive treatment
of patients with conversion disorder (see Table 37–1).
The first step is a thorough neurological and medical evaluation.
As discussed previously, neurological conditions may coexist with
conversion disorder. Moreover, several earlier researchers (Gould et al. 1962; Slater and Glithero 1965) found
that when followed longitudinally, 21%–30% of patients
initially diagnosed with conversion disorder were eventually found
to have an actual neurological disorder or other organic illness
that apparently accounted for the original presentation. Other studies
have found that fewer than 30% of cases of conversion disorder
are incorrectly attributed to a medical cause (Carter 1949; Dickes 1974; Folks et al. 1984; Hafeiz 1980; Watson and Buranen 1979). Advances in medical technology and better
diagnostic techniques have dramatically improved physicians' ability
to accurately diagnose previously "obscure" medical
and neurological conditions. In fact, a 4 year follow-up
study (Kent et al. 1995) found that only 13% of
patients with conversion disorder were initially misdiagnosed. Still,
the fact remains that a sizable number of patients initially diagnosed
with conversion disorder have yet-undiagnosed medical conditions
(Ford and Folks 1985; Mace and Trimble 1996).