A 22-year-old woman is admitted to the hospital because of right-hand anaesthesia, that developed after an argument with her brother. She is in good spirits and seems unconcerned about her problem. There is no history of physical trauma. The neurologic examination is negative EXCEPT for reduced sensitivity to pain in a glove-like distribution over the right hand. Her entire family is in attendance and is expressing great concern and attentiveness. She ignores her brother and seems unaware of the chronic jealousy and rivalry described by her family. The most likely diagnosis is
(D) Conversion disorder # Conversion disorder is characterized by symptoms or deficits of die voluntary motor or sensory functions dial cannot be explained by neurological or other medical conditions.> These symptoms are precipitated by psychological conflicts.> Term 'Hysteria' was used in die nineteenth century (and die first versions of die DSM) to describe syndromes similar to conversion disorder.> It is not a legitimate diagnostic term anymore and it has a negative connotation in general use.> Patients with body dysmorphic disorder are preoccupied wide in-existent or wry minor physical imperfections, often at a delusional level.> Patients with brain tumors present with motor, behavioral and neuropsychiatry symptoms dial vary depending on the localization of die tumors.> Patient's lack of anxiety and apparent lack of awareness of the conflicts with her brother are classic findings In conversion disorder and they are described as called "Primary gains."> This term refers to the use of physical symptoms to express a conflict, emotion, or desire with-in allowing it to enter the patient's consciousness.> Patient's enjoyment other family's attention is a form of "Secondary gain." Secondary gains, being experienced as plea sur- able, reinforce the symptoms.> There is no such dying as "Tertiary gain."> Suppression is a mature defense mechanism and consists of a voluntary decision to put a disturbing thought temporarily o.it of the conscious mind.> "indifference reaction" is associated with right hemispheric lesions and consists of symptoms of indifference toward failures and physical difficulties and lack of interest in family and friends.
Body dysmorphic disorder
Histrionic personality disorder
Parietal brain tumor
Conversion disorder
Miscellaneous (Pharmacology)