Department of Physical Medicine and Rehabiltation, University of Western Ontario and London Health Sciences Centre, University Campus, London, Ontario, Canada.
Psychological Services, University of Western Ontario and London Health Sciences Centre, University Campus, London, Ontario, Canada.
NeuroRehabilitation. 1997;8(3):163-74. doi: 10.3233/NRE-1997-8303.
Conversion disorders are unexplained symptoms or deficits that mimic neurological problems and affect voluntary motor and sensory functions. Historically, conversion symptoms were thought to reflect underlying psychological conflicts although recent behavioural theories view them as learned responses to stressful life circumstances and emphasize environmental contingencies in the maintenance of the disorder. Although early studies often revealed underlying organic disease in patients initially diagnosed with Conversion Disorder, this now occurs less frequently because of increased sophistication of diagnostic tools and better understanding of neurological disorders. However, misdiagnosis is still common because of reliance on 'negative' diagnostic testing and unvalidated 'positive signs' misinterpreted as indicative of hysteria. Psychological factors may affect the course of almost every major category of disease and in many cases a diagnosis of hysteria is not indicated and the more appropriate diagnosis is Psychological Factors Affecting A Medical Condition. It is not possible to definitively differentiate between conscious and unconscious production of symptoms thus blurring the distinction between Conversion and Factitious disorders.
转换障碍是一种无法解释的症状或缺陷，模仿神经系统问题，并影响随意运动和感觉功能。历史上，转换障碍被认为反映了潜在的心理冲突，尽管最近的行为理论将其视为对生活压力的习得性反应，并强调环境对疾病维持的影响。尽管早期的研究经常在最初被诊断为转换障碍的患者中发现潜在的器质性疾病，但由于诊断工具的日益复杂和对神经系统疾病的更好理解，这种情况现在较少发生。然而，由于依赖“阴性”诊断测试和未经证实的“阳性体征”被误解为暗示歇斯底里，误诊仍然很常见。心理因素可能会影响几乎每一大类疾病的病程，在许多情况下，歇斯底里的诊断并不适用，更合适的诊断是影响医疗状况的心理因素。因此，转换障碍和人为障碍之间的区别变得模糊，无法明确区分有意识和无意识地产生症状。
