You are on page 1of 9

Conversion disorder From Wikipedia, the free encyclopediaJump to: navigation, search Conversion diso rder Classification and external

resources ICD-10 F44 ICD-9 300.11 DiseasesDB 1645 MedlinePlus 000954 eMedicine emerg/112 med/1150 MeSH D003291 Conversion disorder causes patients to suffer apparently neurological symptoms, such as numbness, blindness, paralysis, or fits, but without a neurological caus e. It is thought that these problems arise in response to difficulties in the pa tient's life, and conversion is considered a psychiatric disorder in the Diagnos tic and Statistical Manual of Mental Disorders fourth edition (DSM-IV).[1] Formerly known as "hysteria", the disorder has arguably been known for millennia , though it came to greatest prominence at the end of the 19th century, when the neurologists Jean-Martin Charcot and Sigmund Freud and psychiatrist Pierre Jane t focused their studies on the subject. Before Freud's studies on hysteria, peop le who suffered from physical disabilities that were not caused by any physical impairments, known as hysterical patients, were believed to be malingering, suff ering from weak nerves, or just suffering from meaningless disturbances. The ter m "conversion" has its origins in Freud's doctrine that anxiety is "converted" i nto physical symptoms.[2] Though previously thought to have vanished from the we st in the 20th century, some research has suggested it is as common as ever.[3] The DSM-IV classifies conversion disorder as a somatoform disorder while the ICD -10 classifies it as a dissociative disorder. Contents [hide] 1 Definition 2 History 3 Presentation 4 Mass psychogenic illness 5 Diagnosis 5.1 Exclusion of neurological disease 5.2 Exclusion of feigning 5.3 Establishing a psychological mechanism 6 Causes 7 Epidemiology 7.1 Frequency 7.2 Culture 7.3 Gender 7.4 Age 8 Treatment 9 Prognosis 10 See also 11 References [edit] DefinitionDSM-IV defines conversion disorder as follows: One or more symptoms or deficits are present that affect voluntary motor or sens ory function suggestive of a neurologic or other general medical condition. Psychological factors are judged, in the clinician's belief, to be associated wi th the symptom or deficit because conflicts or other stressors precede the initi ation or exacerbation of the symptom or deficit. A diagnosis where the stressor

Charcot specialised in treating patients who were suffering from a variety of unexplained physical symptoms inc luding paralysis. but these have been incrementally removed from successive version s.[8] [edit] PresentationConversion disorder can present with motor or sensory symptom s including any of the following: . for example. after appropriate investigation. physicians such as Silas Weir Mitchell in the US and Paul Briquet and Jean-Martin Charcot in France developed ideas about pat ients sharing unexplained neurological symptoms. does not oc cur exclusively during the course of somatization disorder. contractures (muscles which contract and cannot be relaxed) an d seizures. problems or needs. He viewed these apparently neurological symptoms as a result of the conversion of intrapsychic distress in to physical symptoms. which served to relieve the patient's anxiety. In fact.precedes the onset of symptoms by up to 15 years is not unusual. of the neck cramps. cannot be explained ful ly by a general medical condition. This distress was thought to cause the brain to unconsciou sly disable or impair a bodily function as a side effect of the original repress ion. Some of these patients sporadically and compulsively adopted a bizar re posture (christened arc-de-cercle) in which they arched their body backwards until they were supported only by their head and their heels.[7] may actually have suffered from organic ill ness. the F44 cl ass). The symptom or deficit is not intentionally produced or feigned (as in factitiou s disorder or malingering). must each meet the following general criteri a: No evidence of a physical disorder that can explain the symptoms that characteri ze the disorder (but physical disorders may be present that give rise to other s ymptoms). such as "Anna O. The symptom or deficit is not limited to pain or sexual dysfunction. in addition to specific cri teria for each individual disorder. with the explicit suggestion that dissociative and conversion symptoms pro bably share common psychological mechanisms. The nature of the association between the psychological factors and the neurolog ical symptoms remains unclear. the direct effects of a substance. regularl y become attached to these. Convincing associations in time between the symptoms of the disorder and stressf ul events." Freud believed that all hysterical symptoms ultimat ely have some organic components. The term "conversion disorder" originated with Freud.". however. The symptom or deficit causes clinically significant distress or impairment in s ocial. in Studies On Hysteria in which Breuer's Anna O.e. Freud wrote this: "Others of the patient's symptoms were not of a hyst erical nature at all. Hysterical symptoms. case was first p resented.[4] [edit] HistoryIn the 19th century. the dissociative [con version] disorders class includes 10 disorders that. The tenth revision of the World Health Organization's International Classificati on of Diseases uses the term "conversion" as an alternative descriptor for the d issociative disorders class of mental and behavioural disorders (i. which I con sider a modified version of migraine and which as such are not to be classified as a neurosis but as an organic disorder.[5] However. This is true. some have claime d that patients do remain distressed by their symptoms in the long term[6] It has also been suggested that at least some of the classic psychoanalytic case s of hysteria. and is not better ac counted for by another mental disorder.[4] In ICD-10. occupational. or other important areas of functioning or warrants medical evaluation. Earlier versions of the DSM-IV employed psychodyn amic concepts. or as a cu lturally sanctioned behavior or experience. The symptom or deficit.

[9] [edit] Mass psychogenic illnessMain article: Mass psychogenic illness The DSM-IV-TR does not have specific diagnosis for mass psychogenic illness but the text describing conversion disorder states that "In 'epidemic hysteria. it is not uncommon for patients with neurological disease to al so have conversion disorder.[13] Another feature thought to be important was that symptoms would tend to be more severe on the non-dominant (usually left) side. release of epinephrine is a well-demonstrated cause . The neurologist must carefull y exclude neurological disease. with publication bias the most likely explanation for th is commonly held view. but instead follow the individual's conceptualization of a condition. epilepsy or hypokalemic periodic paralysis. double vision Impaired hearing (deafness) Loss or disturbance of touch or pain sensation Conversion symptoms typically do not conform to known anatomical pathways and ph ysiological mechanisms.Motor symptoms or deficits: Impaired coordination or balance Weakness/paralysis of a limb or the entire body (hysterical paralysis or motor c onversion disorders) Impairment or loss of speech (hysterical aphonia) Difficulty swallowing or a sensation of a lump in the throat Urinary retention Psychogenic non-epileptic seizures or convulsions Fixed dystonia unlike normal dystonia[clarification needed] Tremor. Typically. the exclusion of feigning. [edit] Exclusion of neurological diseaseConversion disorder presents with sympto ms that typically resemble a neurological disorder such as stroke. and the determin ation of a psychological mechanism. myoclonus or other movement disorders Gait problems (Astasia-abasia) Syncope (fainting) Sensory symptoms or deficits: Impaired vision (hysterical blindness).[11] In excluding neurological disease. but common in conversion.' sha red symptoms develop in a circumscribed group of people following 'exposure' to a common precipitant. or more simply just that it was "easier" to live with a functional deficit on the non-dominant side.[14] Although agitation is often assumed to be a positive sign of conversion disorder. The validity of many of these signs has been questioned. through examination and appropriate investigatio ns. there were a variety of theories such as the relative involvement of cerebral hemispheres in emotional processin g." [edit] DiagnosisThe diagnosis of conversion disorder involves three elements: th e exclusion of neurological disease. In a late r study no evidence was found that patients with "functional" symptoms are any m ore likely to exhibit this than patients with a confirmed organic disease. the less medical knowledge a person has. Each of these has difficulties.[10] However. the neurologist has traditionally relied part ly on the presence of positive signs of conversion disorder — certain aspects of t he presentation that were thought to be rare in neurological disease. by a study showing that they also occurred in neurological disease. for example.[12] One su ch symptom. However. described in DSM-IV as "a relat ive lack of concern about the nature or implications of the symptoms". a literature review of 121 studies established that this was not true. the more impla usible are the presenting symptoms. is La belle indifférence. Persons with more sophisticated medical know ledge tend to have more subtle symptoms and deficits that may closely simulate n eurological or other general medical conditions. however . multiple scle rosis.

the other great theoretician of hysteria.of paralysis from hypokalemic periodic paralysis. Unfortunately. in a patient with conversion. including some which suggest that blood flow i n patients brains may be abnormal while they are unwell. Freud later argued that the repressed experiences were of a sexual n ature. As researchers identify the mechanisms which underlie conversion symptoms it is ho ped these will allow the development of a neuropsychological model.[30] There has been much recent interest in functional neuroimaging in conversion.[28] Support for the diss ociation model comes from studies showing heightened suggestibility in conversio n patients.[31] An evolutionary psychology explanation for conversion disorder is that the sympt . Later authors have attempted to combine elements of th ese models. acting on a personality vulnerable to dissociation. T rue rates of feigning in medicine remain unknown. DSM-IV requires that the clinician believe preceding stressors or conflicts to be associated with the dev elopment of the disorder. such as a false identity.[26] Some support for the Freudian model comes from findings of high rates of childho od sexual abuse in conversion patients[27] and from a recent neuroimaging study showing abnormal emotion processing of a traumatic event linked to motor process ing of the affected limb. or is "caught out" in a bro ader deception.[19] [edit] Exclusion of feigningConversion disorder is unique in DSM-IV in explicitl y requiring the exclusion of deliberate feigning.[22] [edit] Establishing a psychological mechanismThe psychological mechanism can be the most difficult aspect of the conversion diagnosis. A 2007 review stated that conversion disorder and dissociative disorders are sta tistically associated.[6][18] and a meta-a nalysis has shown that misdiagnosis rates since that paper are around 4%.[15] The process of exclusion is not perfect. [25] In this hypothetical process. Eliot Slater demonstrated that misdiagnos es had occurred in one third of his 112 patients with conversion disorder. These have all been too small to be confident of the generalisability of their findings. however. though how this might come about is still the subject of debate. however. so no neuropsychological model has been clearly established. though neurological presentati ons of feigning may be among the more common. resulting in paralysis or numbness in that leg. rather than a clinical technique. share features such as a history of abuse and high sugges tibility. In a highly influential[16] study from the 1960s. [edit] CausesThe original Freudian model[2] suggested that the emotional charge of painful experiences would be consciously repressed as a way of managing the p ain.[20] One neuroimaging study suggested t hat feigning may be distinguished from conversion by the pattern of frontal lobe activation. A number of such studies have been performed. and likely have common underlying causes. the subject's experience of their leg.[21] however this is a research.[29] and in abnormalities in motor imagery. so misdiagnoses will occur. this is only li kely to be demonstrable where the patient confesses. is split-off from the rest of their consciousness. It recommended that DSM shou ld follow ICD-10 and reclassify conversion disorder from a somatoform disorder t o a dissociative disorder. the sa me as for other neurological diseases. for ex ample. argued that symptoms arose thro ugh the power of suggestion. conversion has 'the doubtful distinction among psychiatric diagnoses of still invoking Freudian mechanisms'[24] Janet.[17] L ater authors have argued that the paper was flawed. but this emotional charge would be somehow "converted" into the neurologica l symptoms. but none of them has a firm empirical basis.[23] As Peter Halligan comments.

Explanation. and the gender difference in prevalence. There is little evidence-based treatment of conversion disorder.[38] Many authors have found occurrence of conversion to be more frequent in rural. This must be clear and coherent as attributing physical symptoms to a psychological cause is not accepted by many educated people in western cult ures. [edit] See alsoConversion syndrome Hysterical contagion . respectively. 2. conversion type").[42] 4. A non-combatant wit h these symptoms signals non-verbally. This can explain that conversion di sorder may develop following a threatening situation. the concept of 'hysteria' was originally understood t o be a condition exclusively affecting women. that there may be a group effect with many people simultaneously developing similar symptoms (as in mass p sychogenic illness). In neurology clinics. evidence of this is limited. possibly to someone speaking a different language. diagno sis of conversion typically requires an additional psychiatric evaluation.Physiotherapy where appropriate. Large scale psychiatric registers in the US and Iceland found incidence rates of 22 and 11 newly diagnos ed cases per 100. though the concept was eventually extended to men. that it is common. 3. clearly identifiable stress at this time.6%.[43][full citati on needed] Other treatments such as cognitive behavioral therapy.Treatment of comorbid depression or anxiety if present. hypnosis. It must emphasize the genuineness of the condition. pot entially reversible and does not mean that the sufferer is psychotic.000 person-years. with bet ween 2 and 6 female patients for every male. [edit] PrognosisThe DSM-IV-TR states that conversion symptoms will in most cases disappear within 2 weeks in those hospitalized.[33][38] females predominate.[37] [edit] CultureAlthough it is often thought that the frequency of conversion may be higher outside of the West. and s ince few patients will see a psychiatrist[36] it is unclear what proportion of t he unexplained symptoms are actually due to conversion. the reported prevalence of unexplained symptoms among new patients is very high (between 30 and 60%)[33][34][35] However. EMDR . In recent surveys of conversion disorder (formerly classified a s "hysterical neurosis. Taking an etiologically neutral stance by describing the symptoms as functional may be hel pful but further studies are required. Studies suggest a peak onset in the mid-to -late 30s.[3] A community survey of urban Turkey found a prevalence of 5.Occupational Therapy to maintain autonomy in activities of daily living. Acu te may have been evolutionarily advantageous during warfare. and psychodynamic psychotherapy eeg brain biofeedback need further trials.[32] [edit] Epidemiology[edit] FrequencyInformation on the frequency of conversion di sorder in the West is limited. in part due to the complexities of the diagnostic process.[33][37][38] [edit] TreatmentTreatment may include the following:[41] 1. the patient should be followed u p neurologically for a while to ensure that the diagnosis has been understood.[37][39][40] [edit] GenderHistorically. that she or he is not dangerous as a combatant and also may be carryin g some form of dangerous infectious disease. perhaps in relation to cultural and medical attit udes. where technological investi gation of patients is limited and individuals may be less knowledgeable about me dical and psychological concepts. and short time between onset and treatment are associated with a favorable prognosis. Ideally. One-fifth to one-quarter will h ave a recurrence within a year with this also predicting future recurrences. lower socio-economic groups. [edit] AgeConversion disorder may present at any age but is rare in children you nger than 10 years or in the elderly.

Craig TK. Neu rosurgery.^ Stone J. Lehmann-Horn F. 204–9. 1395–99. et al.130(5):793–812. "A follow-up of patients diagnosed as suffering from "hysteria" J Psychosom Res 1965 Sep. 2007 Feb–Mar.) Hysterical Conversion: clinical and theoretical perspectives (pp. "Psychological mechanisms of medically unexplained symptoms: an integrative conceptual model. Smyth R.who. pp. Cope H. Glithero E. BMJ 2005 20.pdf.^ Spence SA.^ Gould R. Grasby PM. "Diagnosis of Hysteria"Br Med J 1965 May." Lancet 2000 Apr 8.^ Krahn L. 18.^ Slater ET. "Dora: Fragment of an analysis of a case of hysteria.^ Freud S. 1–267. J ournal of the Psychoanalytic Association 1987. 355(9211). 1905 24.. Keijsers GP. and Psychiatry. 2006 Mar.Mass hysteria [edit] References1. "Ar e functional motor and sensory symptoms really more frequent on the left? A syst ematic review. & House. et al. Vol 55. "La belle indifference in conversion symptoms and hysteria: systematic review. O'Connor K. 28. 9. Journal of Neurology. David AS. Lewis SC. JR Soc Med 2005.^ Alison Orr-Andrewes. 1163–8.^ Stone. 22. 56–62. Näring GW. Carson A." J Abnorm Psychol. 17. 188 pp. 1920.^ a b Stone. Marshall (Ed s. 2000. Bass.O. 23. 14. Hongzhe L. 160(6).. 1992. C. Goldbeck R.^ ( Breuer and Freud.." J Neurol Neurosurg Psychiatry. 2002 . Moene FC. "Hypnot ic susceptibility in patients with conversion disorder. H. pg. Carson A. "The Prognosis of Hysteria" In Moene FC.9(1) pp. 320:1488–1489. Four th Edition.159(11):1908–13. Keijsers GP.^ Kanaan RA. Warlow C." Br J Psychiatry." Psychol Bull. Benson D F. The validity of hyster ical signs and symptoms.73(5) pp. Fourth Edition. 2003. Sandijck P. 2001. 593–597 13. 98:547–548 7. pp. Ameri can Psychiatric Association 10. A. 25.^ Diagnostic and Statistical Manual of Mental Disorders. Inc.^ a b The ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines.^ Brown. 8. Oxfo rd: Oxford University Press. 174. pp. 2005. http ://www. 21.^ Ron M. The epidemiology of hysterical conversion . 5. Thomas B. "Childhood abuse i n patients with conversion disorder. pp." Am J Psychiatry. Jurkat-Rott K. World Health Organization. "Factitious disorders in the field of neurology and psychiatry. "Studies in Hysteria"." American Journal of Psychiatry. 578–81. Crimlisk HL.^ Roelofs K. Derick T Wade. American Psychiatric Association 2.^ "Segal MM. 19. 73–87). "The case of Anna O: A Neuropsychiatric perspective".^ Breuer and Freud. 1 pp. Christopher Bass. "Patients who strive to be ill: Factitious disorder with physical symptoms. Halligan.^ 'New approaches to conversion hysteria.69(2):202–5. no 10. " 1994.96). 62(1–2). "Discrete neurophsyiolog ical correlates in prefrontal cortex during hysterical and feigned disorder of m ovement. Wessely SC. 9–13. Sharpe M. Journal of Neurology. Neurosurgery and Psychiatry (Neurology in Practice) .. BMJ 2000. pp. RJ.399. 27.^ a b Akagi.. 15. vol 35 p. E. Functional symptoms in neurology: Asses sment. 76 (Suppl 1): 2–12 11. Levitt J. 4.^ Stone J. 1986. Oxford: Oxford University Press. 2004 Sep. 1895 3. In P.." Psychosom Med. "Imaging repressed memories in m otor conversion disorder. J. Warlow CP.".^ a b Josef Breuer & Sigmund Freud. "The Major Symptoms of Hysteria".^ Stone J. owner's manual" 16. Sharpe M.^ Eckhardt A. *Studies on Hysteria* Basic Books. 29. "Studies in Hysteria".^ Slater.^ Roelofs K. 1243–4. Miller B L. 73–87).^ Diagnostic and Statistical Manual of Mental Disorders. Peter W Halligan. 1895 6.^ Janet. Halligan. Sharpe M. Näring GW. Goldberg M A. Hoogduin KA. 2002 Nov. "Hysteria following brain injury". vol. Carson A. 2nd Edition 26. 1046–1053 12. Bass. The Journal of nervous and mental disease.^ Eames P. P.) Hysterical Conversion: clinical an d theoretical perspectives (pp. 3 June. C. Hoogduin KA. 2002 Nov. Ron MA. Hypokalemic periodic pa ralysis . Marshall (Eds.

(2007).. Klumpers UM.^ Ruddy R. PMID 17878494. J. Ron MA.5. V. doi:10. "Motor initiation and ex ecution in patients with conversion paralysis. Warlow C. 2005 Mar. de Leeuw FE. "Medically unexplained symptoms: an epidemi ological study in seven specialities. E. " J Neurol Neurosurg Psychiatry.369.doctorsofusc." J Neurol Neurosurg Psychiatry. 30. 2000 Sep. 2001 Jul. Turkey. (2006). Psychosocial interventions for conversion disorder.^ Brown.84(3):288–93. "Functional symptoms in neurology: management.^ Crimlisk HL. Taskin O. Issue 4. House A. Psychosomatics 48 (5): 369–378. 2004 Jan. 42. McKenzie L.pub2 [show]v ·t ·eMental and behavioral disorders (F 290–319) [show] Neurological/symptomatic Dementia Mild cognitive impairment ·Alzheimer's disease ·Multi-infarct dementia ·Pick' s disease ·Creutzfeldt–Jakob disease ·Huntington's disease ·Parkinson's disease ·AIDS deme ntia complex ·Frontotemporal dementia ·Sundowning ·Wandering Autism spectrum Autism ·Asperger syndrome ·Savant syndrome ·PDD-NOS ·High-functioning au tism Other Delirium ·Post-concussion syndrome ·Organic brain syndrome . Tezcan E. Marsden D. Progress in Neuro-Psychopharmacology and Biological Psychiatry 3 0 (5): 827–853.1176/appi.111(2):390–5.251(1):66–71.51(1):361–7. Dinc G. Keijsers GP." J Psychosom Res.68(2):207–10. David AS.^ Bracha. 2000 Feb . Cochr ane Database of Systematic Reviews 2005.: CD005331.^ a b c Stefánsson JG.76 Suppl 1:i13–21." J Psychosom Res. Demet MM.1016/j. doi:10.psy.." Soc Psychiatry Psychiatr Epidemiol. "Sociodemographic and cli nical characteristics of patients with conversion disorder in Eastern Turkey." Acta Psychiatrica Scandin avica 1976 Feb.01." Acta Psychiatrica Scandinavica 1991 S ep.11 0(1):21–34.^ http://www. 35. Bulut S.^ Tomasson K.CD005331. 2007 Nov. No.42(11):85 7–64. Kappelle LJ. Messina JA. Carson A. van Gijn J.2006. 36. Atmaca M. "Human brain evolution and the "Neuroevolutionary Time-d epth Principle:" Implications for the Reclassification of fear-circuitry-related traits in DSM-V and for studying resilience to warzone-related posttraumatic st ress disorder". Kaya E.^ Roelofs K.. PMID 16563589.100 2/14651858. Sharpe M. 34. "Somatization and conversion disorders: como rbidity and demographics at presentation.^ Snijders TJ. "Hysterical neurosis. 38. Meyerowitz S. Kent D. 39.48. 2002 May. 31.008. E.^ a b c Carson AJ. Sharpe M.38(2):88–93. Ringbauer B. Bhatia KP.49(3):217–9.^ Kuloglu M. Erbay-Dundar P. Wessely S. 37. Hoogduin CA. doi:10. Cope H. Yilmaz H. conversi on type: clinical and epidemiological considerations.^ Nimnuan C. "Prevalence of pseudoneurologic conversion disorder in an urban comm unity in Manisa.pnpbp. "Should Conversion Disorder Be Reclassified as a Dissociative Disorder in DSM V ?"." Acta Psychol (Amst). edit 33.^ Stone J. "Prevalence and predictors of unexplained neurological symptoms in an academic neurology ou tpatient clinic—an observational study. "Do medically unexplained symptoms matter? A prospective cohort study of 300 new ref errals to neurology outpatient clinics. Cardena." S oc Psychiatry Psychiatr Epidemiol.May. van Galen GP.53(2):119–38. R.. 40. 41. Coryell W. "Patterns of r eferral in patients with medically unexplained motor symptoms. Sar. Nijenhuis. edit 32. O. Van Der Hart. 2003 Feb. 43.^ a b c Deveci A. Ozmen E. Stone J." J Neurol. Hotopf M. Gecici O. Art.

substance abuse.[show] Psychoactive substances. stress-related and somatoform Anxiety disorder Phobia Agoraphobia ·Social anxiety ·Social phobia ·(Anthropophobia) ·Sp ecific phobia ·(Claustrophobia) ·Specific social phobia Other Panic disorder ·Panic attack ·Generalized anxiety disorder ·OCD ·stress ·(Acute stre ss reaction ·PTSD) Adjustment disorder Adjustment disorder with depressed mood Somatoform disorder Somatization disorder ·Body dysmorphic disorder ·Hypochondriasis ·Nosophobia ·Da Costa's syndrome ·Psychalgia ·Conversion disorder ·(Ganser syndrome ·Globus pharyngis) ·Neurasthenia ·Mass Psychogenic Illness Dissociative disorder Dissociative identity disorder ·Psychogenic amnesia ·Fugue sta te ·Depersonalization disorder [show] Physiological/physical behavioral Eating disorder Anorexia nervosa ·Bulimia nervosa ·Rumination syndrome ·NOS Nonorganic sleep disorders (Nonorganic hypersomnia ·Nonorganic insomnia) ·Parasomnia ·(REM behavi or disorder ·Night terror ·Nightmare) Sexual dysfunction sexual desire ·(Hypoactive sexual desire disorder ·Hypersexuality)sexual arousal ·(Female sexual arousal disorder) ·Erectile dysfunctionorgasm ·(Anorgasmia ·Del ayed ejaculation ·Premature ejaculation ·Sexual anhedonia)pain ·(Vaginismus ·Dyspareunia ) . drug abuse and substance-relat ed disorders Intoxication/Drug overdose ·Physical dependence ·Substance dependence ·Rebound effect ·D ouble rebound ·Withdrawal [show] Schizophrenia. schizotypal and delusional Psychosis Schizoaffective disorder ·Schizophreniform disorder ·Brief reactive psycho sis Schizophrenia Disorganized schizophrenia ·Delusional disorder ·Folie à deux [show] Mood (affective) Mania ·Bipolar disorder ·(Bipolar I ·Bipolar II ·Cyclothymia ·Bipolar NOS) ·Depression ·(Majo depressive disorder ·Dysthymia ·Seasonal affective disorder ·Atypical depression ·Melan cholic depression) [show] Neurotic.

a.Postnatal Postpartum depression ·Postnatal psychosis [show] Adult personality and behavior Sexual and gender identity Sexual maturation disorder ·Ego-dystonic sexual orientation ·Sexual relationship disorder ·Paraphilia ·(Voyeurism ·Fetishism) Other Personality disorder ·Impulse control disorder ·(Kleptomania ·Trichotillomania ·Py romania ·Dermatillomania) ·Body-focused repetitive behavior ·Factitious disorder ·(Münchau sen syndrome) [show] Mental disorders diagnosed in childhood Mental retardation X-Linked mental retardation ·(Lujan-Fryns syndrome) Psychological development (developmental disorder) Specific ·Pervasive Emotional and behavioral ADHD ·Conduct disorder ·(ODD) ·emotional disorder ·(Separation anxiety disorder) ·social functioning ·(Selective mutism ·RAD ·DAD) ·Tic disorder ·(Tourette syndrome) ·Speech ·(Stuttering ·Cluttering) ·Movement disorder ·(Stereotypic) [show] Symptoms and uncategorized Catatonia ·False pregnancy ·Intermittent explosive disorder ·Psychomotor agitation ·Sexu al addiction ·Stereotypy ·Psychogenic non-epileptic seizures ·Klüver-Bucy syndrome M: PSO/PSI mepr dsrd (o. sysi/epon. d. spvo proc(eval/thrp). drug(N5A/5B/5C/6A/6B/6D) Somatization disorder Body-centred countertransference . p. m. s). p.