Alper proposed an important distinction between consciousness and unconsciousness and intentional and non-intentional PNES (8,45), identifying three different groups: in the first group, PNES are defined as a conversion disorder
, in which patients are not conscious of intentionally producing symptoms or of the unconscious conflict underlying their occurrence; in the second group (PNES as factitious disorder), patients are aware of the intentionality of their symptoms but not of their reason for pursuing the sick role in their lives; in the last group, PNES occur in the context of malingering and patients are aware of intentional symptoms and of the underlying reasons.
Conversion disorder should be differentiated from other disorders.
Of importance is the fact that between 25 to 50% of patients diagnosed with conversion disorder will subsequently be diagnosed with an organic medical condition.
Clinically, the diagnosis of conversion disorder is one of exclusion.
Diagnosis and management of psychogenic stridor caused by a conversion disorder.
Prevalence rates of conversion disorder have ranged from as low as 11/100,000 to as high as 300/100,000 in the general population (DSM-IV, 1994; Ford & Folks, 1985).
Finally, the critical difference between conversion disorder and malingering is intent.
Like other conversion disorders
, NES does not involve a chronic disturbance of consciousness or rationality.
Psychogenic movement disorders and other conversion disorders
such as psychogenic Parkinsonism, conversion paralysis, and dissociative disorders are common "illnesses without a [bioemedically verifiable] disease," but understanding of their mechanisms remains sketchy.
are typically first seen by emergency physicians and primary care providers.
(CD) refers to a disturbance of body function characterized by neurological sensory or motor symptoms in which known medical states do not explain, or fail to account for, the severity of the patient's impairment (11.
3] When modern psychotherapy was ushered in during the 19th century, it was the patient with conversion disorder
who became the focal point for the debate between psychogenic and biogenic theories.