Clinical features and outcome of conversion disorders in children and adolescents

Background: To study the prevalence, clinical correlates and outcome of Conversion Disorders (CD) in children and adolescents. Methods: All the children and adolescents receiving ICD-10 diagnosis of Conversion Disorder during the period of July 2008 to June 2009 constituted the study sample. Results: During the 12 months period, a total of 332 children and adolescents were evaluated. 41 (12.5%) received the ICD-10 diagnosis of CD. 53% of the subjects were in the age group of 12-16 years. Majority (61%) of them were girls. 56% had an acute onset of illness (<2 weeks). Most common conversion symptom noticed was convulsions (pseudoseizures) followed by dissociative motor symptoms. About ninety percent of the subjects had one or more significant psychosocial stressor. 12 (30%) had positive family history of mood disorder and dissociative disorder. 93% showed remission within a month. During the period of next 18 months a total of 6 children were lost to follow-up. Out of remaining 35 children, 3 had relapsed; 2 presented with the same symptoms as that of initial presentation and one with different symptoms. Rest of the children were functioning normally and had resumed schooling. Conclusion: CD in Indian children and adolescents is not uncommon as is shown by Western literature. It has a good outcome. Early diagnosis and presence of precipitating factor are predictors of good outcome.