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Hysteria, conversion and functional disorders: a neurological contribution to classification issues

  • Edward H. Reynolds (a1)
Summary

Proposals by psychiatrists to reclassify conversion disorder in DSM-5 and ICD-11 are proving difficult and controversial. Patients with conversion disorder usually present initially to neurologists, who often use different concepts and terminology. History and clinical practice suggest that the way forward is to seek agreed principles and a common understanding between the two disciplines, preferably in a single universal classification.

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References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Hysteria, conversion and functional disorders: a neurological contribution to classification issues

  • Edward H. Reynolds (a1)
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eLetters

Re: Hysteria, Conversion and Functional Disorders

Michael Fitzgerald, Psychiatrist
03 November 2013

Dear Sir,

Reynolds suggests that Conversion Disorder was "influenced by the psychoanalytic theory of Freud". This is correct but Pierre Janet had described this before Freud.

Yours sincerely

Professor Michael Fitzgerald, M.C.004541 Consultant Child & AdultPsychiatrist Department of Psychiatry Trinity College Dublin Dublin 2 Ireland

Reynolds, E.H. Hysteria, Conversion and Function Disorders: A Neurological Contribution to Classification Issues. British Journal of Psychiatry 2012 (2001, 253-254). 2 Janet P. L'Anesthesie Hysterique Archives de Neurologie, 1892, 23: 323- 352.

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Conflict of interest: None declared

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Functional - meanings and connotations

Geetha Desai, consultant psychiatrist
14 November 2012

The editorial by Reynolds has discussed the terms hysteria, conversion, functional disorders and highlighted the limitations of these terminologies. The hysteria term has taken a bow out of the classificationtheatre, but 'functional' is still in use. The term "functional" has many meanings and connotations as highlighted by the author. We discovered moreinterpretations of the term "functional" recently. In a survey among mental health professionals the meaning of term "functional" in the context of medically unexplained symptoms was elicited. The responses wereinteresting and enlightening. Apart from the common response, that 'functional' is ' non organic', the interesting responses were 'being functional' that is 'able to function on activities of daily living', 'being functional in an occupation' and also included 'being able to attend a function'. With the use of 'functional MRI', the term 'functional' will add to the confusion in clinical practice. Thus, the same term carried multiple meanings to different people. Hence it may be better to avoid the term 'functional' and use more acceptable term, if any.

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Conflict of interest: None declared

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