School of Psychological Sciences at the Universityof Manchester, England.
Psychiatry. 2011 Fall;74(3):187-206. doi: 10.1521/psyc.2011.74.3.187.
The diagnostic criteria and related features of conversion disorder are under revision for DSM-5, including the requirement that psychological factors accompany the symptoms or deficits in question (Criterion B) and whether conversion disorder should be re-labeled as a dissociative, rather than a somatoform, condition. We examined the cross-cultural evidence on the prevalence, characteristics, and associated features of pseudoneurological symptoms more generally, and conversion disorder in particular, in order to inform the ongoing re-evaluation of the conversion disorder category. We also examined the relationship between these constructs and dissociative symptoms and disorders across cultural groups. Searches were conducted of the mental health literature, particularly since 1994, regarding culture, race, or ethnicity factors related to conversion disorder. Many proposed DSM-5 revisions were supported, such as the elimination of Criterion B. We also found cross-cultural variability in predominant symptoms, disorder prevalence, and relationship with cultural syndromes. Additional information that may contribute to DSM-5 includes the elevated rates across cultures of traumatic exposure and psychiatric comorbidity in conversion disorder. Cross-culturally, conversion disorder is associated strongly with both dissociative and somatoform presentations, revealing no clear basis on which to locate the disorder in DSM-5. Careful consideration should be given to the possible alternatives.
转换障碍的诊断标准和相关特征正在为 DSM-5 进行修订，包括要求心理因素伴随所讨论的症状或缺陷（标准 B），以及是否应将转换障碍重新标记为分离症，而不是躯体形式障碍。我们研究了更广泛的神经症样症状，特别是转换障碍的跨文化证据，以了解正在进行的转换障碍类别的重新评估。我们还研究了这些结构与跨文化群体的分离症状和障碍之间的关系。针对与转换障碍相关的文化、种族或民族因素，对心理健康文献，特别是自 1994 年以来的文献进行了检索。许多建议的 DSM-5 修订得到了支持，例如删除标准 B。我们还发现了主要症状、疾病流行率和与文化综合征关系的跨文化变异性。可能有助于 DSM-5 的其他信息包括转换障碍中创伤暴露和精神共病的发生率在不同文化中均较高。在跨文化环境中，转换障碍与分离和躯体形式表现强烈相关，这表明没有明确的依据将该障碍定位在 DSM-5 中。应仔细考虑可能的替代方案。
