Psych: Conversion Disorder: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Conversion Disorder (Functional Neurological Symptom Disorder)
🎧 A focused, high-yield revision breakdown of conversion disorder, pulling out everything you need to know for exams and clinical practice.

🧠 Key Learning Points

📌 Definition
• Conversion disorder (Functional Neurological Symptom Disorder) involves neurological symptoms—like paralysis, tremor, loss of sensation, visual or speech disturbance—that are not explained by any medical disease.
• Symptoms are not consciously produced or feigned.

📌 Causes & Pathophysiology
• Linked to psychological factors: unresolved stress, emotional conflict, or trauma
• Symptoms are thought to arise from disrupted brain-body communication; precise biological mechanisms remain unclear
• May involve abnormal function in areas controlling movement and emotion

📌 Risk Factors
• History of trauma or abuse
• Other psychiatric conditions (anxiety, depression)
• Prior neurological illness or injury
• Personality traits (difficulty expressing emotions, “alexithymia”)
• More common in females and those with previous mental health diagnoses
• Can occur at any age

📌 Clinical Features
• Sudden onset of neurological symptoms (motor: limb weakness, paralysis, abnormal gait; sensory: numbness, vision loss, hearing disturbance; or non-epileptic seizures)
• Symptoms inconsistent with recognised disease patterns
• May shift or fluctuate over time
• La belle indifférence (apparent lack of concern) may be present, but not always
• Commonly triggered by psychological stress

📌 Diagnosis
• Clinical diagnosis—requires careful history, examination, and neurological assessment
• Rule out genuine neurological/medical conditions (stroke, MS, epilepsy, neuropathies) and other psychiatric/somatic symptom disorders
• Exclude malingering (symptoms for external gain) and factitious disorder (intentional symptoms for psychological gain)
• Relevant investigations (MRI, bloods, EEG, etc.) as needed to exclude organic disease

📌 Management
• Multidisciplinary approach:
 – Psychological therapy: CBT is first-line, helps patients understand the mind-body link
 – Physical rehabilitation: Physiotherapy or occupational therapy as indicated
 – Address psychiatric comorbidities: Treat depression, anxiety
 – Education and reassurance—explaining the nature of the disorder and that symptoms are genuine but reversible in many cases
• Regular follow-up and monitoring for new symptoms or complications

📌 Complications
• Potential for chronic disability or persistent symptoms if untreated
• Impaired quality of life, work, and relationships
• Risk of depression or anxiety
• High healthcare usage from repeated investigations
• Social isolation and dependency

📎 More MSRA Resources for Conversion Disorder:
📝 Revision Notes: https://www.passthemsra.com/topic/conversion-disorder-revision-notes/
🧠 Flashcards: https://www.passthemsra.com/topic/conversion-disorder-flashcards/
💬 Accordion Q&A: https://www.passthemsra.com/topic/conversion-disorder-accordion-qa-notes/
🚀 Rapid Quiz: https://www.passthemsra.com/topic/conversion-disorder-rapid-quiz/<

Episode Transcript

(00:00):
Welcome back to the Deep Dive. Today we're tackling something,
well, really complex, straight from your revision notes
Conversion disorder. Yeah, it's a fascinating 1.
Our mission is basically to takethese notes, unpack them and
pull out the real high yield stuff.
Make it clear and memorable for you.
Absolutely. It's a topic that sits right at

(00:20):
that mind body interface, doesn't it?
These notes give us a good map and we want to help you navigate
it. OK, let's dive in then.
The definition first, according to the notes, what is conversion
disorder at its core? What's the main thing?
Right. The absolute key thing to
remember is you've got neurological symptoms, things
like weakness, maybe paralysis, blindness, tremors, could even

(00:43):
be seizure like events. OK, but, and this is the crucial
part, these symptoms are inconsistent with any known
neurological disease or other medical condition.
The pattern just doesn't fit. And there's a link to
psychology, right? The notes mentioned something
about unresolved conflicts or distress.
Exactly. It's the conversion idea, you
know, psychological distress is thought to somehow, well,

(01:04):
convert into these physical symptoms.
And critically, it's not deliberate.
No, absolutely not. The person isn't faking it,
They're not consciously producing the symptoms for gain
or anything like that. They genuinely experience them.
The notes mentioned LaBelle indifference, that lack of
concern. Yeah, they mention it, but they
also rightly caution that you don't always see it.

(01:25):
So it's interesting, but not a reliable diagnostic sign on its
own. Don't hang your hat on.
It right. So this is the really intriguing
part. How does this actually happen?
Because the pathophysiology. It sounds pretty complex in the
notes. It really is.
The notes paint a picture of like a disruption, a breakdown
in the normal communication lines between the brain and the

(01:46):
body. It seems to involve
psychological factors, stress, maybe trauma, unconscious
conflicts somehow triggering this physical manifestation, but
the precise sort of biological wires involved, we don't fully
understand them yet. So lot still unknown there.
What about risk factors? Who's more likely to develop
this? The notes point to a few things.

(02:06):
A history of trauma or abuse seems significant.
Also having other psychiatric conditions like anxiety or
depression, or even having had genuine neurological issues in
the past and certain personalityfactors maybe difficulty
handling or expressing emotions.So given these neurological like
symptoms, how do you make sure it's not something else?
What are the key differentials the notes highlight?

(02:28):
Yes, this is absolutely criticalfor practise.
You must rule out actual neurological diseases.
Like stroke or Ms. Exactly. Stroke, Ms, epilepsy.
Depending on the symptoms, then there are other somatic symptom
disorders and importantly you need to distinguish it from
malingering or. Someone is taking for.
Precisely or factitious disorderwhere they fake illness but for

(02:49):
like an internal psychological need, not external gain.
The inconsistency of the symptoms with anatomy is often
the big clue for conversion disorder.
And how often do clinicians actually encounter this?
Is it common? The notes suggest it's
considered rare, especially herein the UK.
Getting exact numbers is tricky there.
It can affect anyone, any age, any gender.

(03:11):
OK. So bringing it all together,
what does it actually look like clinically?
The features seem varied. They really are because they
mimic neurology. You might see motor issues like
a limb weakness that doesn't follow nerve patterns or tremors
that change when distracted, oddgates or sensory problems.
Maybe weird patches of numbness,vision loss that doesn't match

(03:32):
eye exams, hearing issues, even those non epileptic seizures we
mentioned and. The key is the inconsistency.
Yes, the inconsistency with organic disease patterns is
central, and the symptoms can often shift or come and go.
So with all that, what investigations are needed?
Well, the diagnosis itself is largely clinical.
It rests on a really careful history of physical exam and a

(03:55):
thorough neurological assessmentto spot those inconsistencies.
But you still do tests. No, absolutely.
The notes are clear on this. You need appropriate
investigations, maybe brain scans, nerve tests, blood work,
whatever's needed to confidentlyrule out an underlying physical
cause. You can't miss something
treatable. Right, makes sense.
So once the diagnosis is made, how do you manage it?

(04:17):
What's the strategy? It really needs a team approach,
a multidisciplinary 1. The aim is twofold, manage the
physical symptoms and address the underlying psychological
stuff. So therapy.
Yes, psychotherapy is key. The notes mentioned things like
CBT, cognitive behavioural therapy helping change thought
patterns, or maybe psychodynamictherapy exploring deeper issues.

(04:40):
Physical therapy can also be crucial for regaining function.
And keeping an eye on things. Definitely regular follow up is
vital for support and tracking progress.
What's the outlook usually like?Can people get better?
The notes say prognosis varies quite a bit.
With the right support put in place early, many people do see
their symptoms reduced significantly, sometimes resolve

(05:00):
completely. But not always.
No, for some symptoms might linger, maybe become chronic,
needing ongoing management to help them cope and function.
And what are the risks if it's not managed well?
Complications. Well, the.
Biggest 1 is just the impact on daily life.
Work, relationships, independence can all suffer
because of the symptoms. There's also a higher risk of
anxiety or depression alongside it potentially.

(05:23):
Lots of healthcare visits tryingto find answers and just ongoing
distress if it's not properly understood or addressed.
You know what really strikes me here is just how profound that
mind body connection is and how much is Stillwell a bit of a
mystery. How can psychological distress
create such real debilitating physical symptoms that don't

(05:44):
have a clear physical 'cause it's quite something?
It really is. This deep dive based on your
notes really clarifies conversion disorder, showing the
complexity but also giving us that high yield framework.
Nailing these distinctions is soimportant.
Absolutely critical and for anyone revising this or wanting
to learn more, good resources are definitely available.

(06:04):
You can find more high yield content just like this over at
past Ms ray.com. Yeah.
Lots of helpful stuff there. And don't forget the free
resources available to check outfree Ms ray.com.
Worth a look until next time.