Conversion disorders in Nottingham: alive, but not kicking.

A postal request to general practitioners in a catchment area (population 37,000) identified 18 patients fulfilling criteria for conversion disorder (age range 26-74 years; mean age of onset of first episode 38 years). There was a female preponderance, with two patients from ethnic minority groups. There was a temporal correlation with stress in 13 cases (72%) and a history of sexual abuse in 5 cases (28%). Three clinical groups were identified: acute onset with good premorbid functioning and full recovery; conversion symptoms as part of polysymptomatic presentation, with fluctuating course; and chronic, severely disturbed individuals with a past history of sexual abuse. One third of cases were referred to psychiatrists. There was no case of a missed organic disorder. The details of one case are discussed.