The symptoms are physical, distressing, uncontrollable — and all-too-real. But the underlying cause is psychological. That’s what conversion disorder is.
And that, too, was the exact diagnosis given by a New York doctor to the 12 teenage girls he treated recently who had developed—virtually overnight—neurological tics, verbal outbursts and other Tourette’s-like symptoms.
Some of the girls are improving and back in school at New York’s LeRoy High School, while others continue to worsen, says one of two girls who appeared on the Today Show to discuss their plight.
After the sudden outbreak several months ago, the school was immediately tested for all kinds of environmental toxins, but none was discovered, the Le Roy Central School District says.
Infectious and communicable diseases had also been ruled out, says a doctor with the New York State Department of Health.
A battery of tests have ruled out medical disorders, diseases and environmental factors, says neurologist Laszlo Mechtler of the Dent Neurologic Institute in Buffalo, New York, who treated all but one of the 12 girls.
The problem was conversion disorder, he says.
When stress or anxiety manifest in an individual as physical symptoms—including twitching, paralysis or loss of some other function—it’s called a conversion disorder, Mechtler tells the Health Blog.
But when it happens to many people at the same time, it’s mass psychogenic illness or MPI, he says.
Usually MPI happens in close-knit communities like schools and factories when there’s a report or fear of a chemical exposure, toxin or virus. Suddenly, people are reporting dizziness, fainting, coughing or sneezing, he says.
What is conversion disorder?
“It’s a term used so rarely that most of us haven’t heard of it,” notes USA Today’s health writer, Sharon Jayson. “Even mental health professionals say they have read about it in textbooks rather than seen it up close,” she adds.
Conversion disorder, found in the family of somatoform disorders, happens when patients experience physical symptoms—numbness or loss of sensation in a body part, seizures, tingling or crawling sensations—that have no explanation.
Lab tests don’t find any underlying physical or “organic” cause to explain the symptoms and factors like infection, communicable disease and drugs don’t seem to explain the symptoms.
“Conversion disorder is characterized by problems with voluntary motor or sensory function that suggest a neurological or other general medical condition but aren’t fully consistent with known biological causes or explanations,” says David Fassler, a child and adolescent psychiatrist at the University of Vermont in Burlington.
He says such outbreaks are more common in women and are associated with stress or anxiety.
The symptoms of a conversion disorder include the loss of one or more bodily functions, including:
• Inability to speak
• Diagnostic testing does not find any physical cause for the symptoms.
The NIH warns that, “Some doctors falsely believe that conversion disorder isn’t a real condition, and may tell patients the problem is all in their head.”
“However, these conditions are real. They cause distress and cannot be turned on and off at will,” it points out.
It’s in the community
Clinical psychologist Nancy Molitor of Wilmette, Ill., who treats adolescents, says the disorder tends to occur in “close-knit communities where everybody knows everybody.
When she encounters a patient with conversion disorder, “I would want to know about what’s going on in the community culturally and religiously and socially,” she says.
“You have to be in that environment. This is a unique situation, and it’s unusual,” Dr. Mechtler tells USA Today.
This is why he says the publicity surrounding the case doesn’t mean teenage girls around the United States will start exhibiting similar symptoms, he reassures audiences.