Psychosocial Factors in Children and Adolescents with Conversion Disorder

Introduction: In view of the limited studies on the psychosocial environment of children presenting with conversion disorders, the present study was carried out to study the psychosocial factors in children with conversion disorders. Method: 40 patients of Conversion Disorder, who presented with "pseudo seizures" and were diagnosed according to DSM IV criteria, comprised the sample. They underwent detailed psychiatric assessment. The psychosocial events and factors and were elicited by administering the PSLES and by interviewing the parent and child by a semi-structured interview, which covered details of school history, family environment, psychosexual and other behavior: The intellectual level of the patients was assessed by a battery of psychological instruments. Relevant investigations, hormonal assays, radiological, EEG etc. were done wherever necessary. Results: Majority of the patients were educated up to 5th class, had rural domicile and belonged to poor and lower middle SES. They were about equally represented in the two sexes. Borderline Intellectual functioning, improper schooling, family stress and current past/physical illness were present in 37.5-40 % (N=15-16) of the cases. Incidental radiological and EEG findings and unusual status of the child; only son, only child or the youngest child; were present in 33% (N=13) of the cases. Conversion/epilepsy in family/neighbour/friend and improper parenting was encountered in 22.5-20.5% (N=8-9) of the cases. Lastly, recent loss of loved one and sibling rivalry were seen to be significant in 7.5 to 12.5% (N=3-5) of the cases. 80 % of the patients had 2-3 contributory factors; the remaining had either 4 or 5 contributory factors. Conclusion: Stress was apparent in the areas of school, family and body. Greater attention must be paid both by teachers and parents by supervising the children's studies more closely. Parenting skills need to be sharpened for the better functioning of the child. Attention needs to be paid to better physical health during infancy and early childhood. (Contains 3 tables.)