Dividing "hysteria": a preliminary investigation of conversion disorder and psychalgia.

The longstanding diagnostic controversy over the concept of "hysteria" has taken on new significance with the advent and development of the third edition of the Diagnostic and Statistical Manual (DSM-III). The problem of defining hysteria is therefore discussed and re-examined. A retrospective study of cases diagnosed as conversion reaction or hysterical neurosis, conversion type was then completed and analyzed. These cases were redefined using DSM-III criteria and were analyzed using a number of demographic and clinical variables. In a comparison of those patients classified as having conversion and those classified as having psychalgia, no significant differences were found. Those patients under the diagnosis of conversion and those carrying the diagnosis psychalgia differed significantly from a control group of patients with random "neurotic" diagnosis on five variables: a) symptoms are defensive; b) symptoms are expressive; c) secondary gain; d) previous physical trauma; and e) previous conversion symptoms.