Diagnosing hysterical conversion reactions in children.

To assist pediatricians in the early, accurate diagnosis of conversion reactions, a biopsychosocial profile of index patients and families was established. Utilizing a chart audit, all pediatric inpatients with conversion reactions at Children's Hospital Medical Center from July, 1976, through June, 1979, were compared wih controls matched for age and socioeconomic status. Data on the medical history, physical examination, and hospital course were uniformly collected for 105 cases and contrasted with those in 105 controls. The mean age was 12.1 years; 47% were male and 53% were female. Compared to controls, the children with conversion reaction had a higher frequency of recent family stress (97%), unresolved grief reactions (58%), and family communication problems (77%). Three case reports describe the pediatrician's use of the medical history, physical examination, and hospital course to diagnose conversion symptoms.