There is no age limitation for them, hypochondria can start in any age but commonly can be diagnosed on early of adulthood or 20 and 30 years old. Men and women have same probability to suffer from this disorder but based on telegraph.co.uk, one report from Office of National Statistics (ONS) show if women are more likely to report illness than men, but are less likely to die from bad health.

Telegraph.co.uk also report if other groups who were more susceptible to illness included people living in council or association homes, people who had no educational qualifications, people who were unemployed and people who did not own a car, the Daily Mail reported. The report claimed that Scotland had the lowest proportion of hypochondriacs – not because they were less likely to report ill health, but because they were statistically more likely to die within five years of doing so due to high rates of mortality in a number of Scottish towns and cities.

The prevalence of Hypochondriac patients ranges from 0.8-4.5% in the primary care setting, and ranges from 4% to 20% of the general population. People with hypochondria also suffer other disorder on range until 88%, this disorder include anxiety (71%), dysthymic disorder (45.2%), and major depression (42.9%). Besides that, patient can have concurrent disorders in form of somatization (21.4%) and panic disorder (16.7%).

hypochondria disorder

Treatment:
1/3 of Hypochondriac patient experience significant improvement in their condition with this somatoform disorder treatment. Prognosis, 10% of patients can be cured, 65% progress to chronic fluctuating with onset, 25% worse prognosis. In the U.S., it is estimated that between 0.8% and 8.5% of the adult population suffers from hypochondria and this disorder causes over $20 billion a year in unnecessary medical procedures and examinations.

Some hypochondria statistic is still on research.

This disorder such as a chronic sense of concern about the appearance, lacking in confidence and require specialized knowledge to diagnose. The high level BDD statistics make the field of cosmetic surgery and dermatology also conduct in-depth study and found if 6-15% of this medical patients also suffer from body dysmorphic disorder.

General statistical data about body dysmorphic disorder:

Age
Adolescents are particularly vulnerable to this disorder because of emotional and psychological factors are unstable when entering puberty. BDD symptoms that began in adolescence may disappear from time to time, but in some cases have even more chronic because the lack of mental development. This occurs because a certain body part or appearance is a major focus of attention and does not change from time to time.

Gender
Not yet definitely known about the distribution of BDD in men and women, but most of BDD appears in women. BDD symptoms in women and men are different, women are more obsessed with the hair, face and breasts. In men, the attention is more focused on the genitals and muscle problems.

New research
A study conducted in 1995 showed that BDD can be started in children despite

Body dysmorphic disorder statistics

previous evidence showing that the symptoms began in adolescence. They conduct research by studying the functional disorders in 130 patients with BDD and their findings are as follows:
• Social dysfunction: 32% of patients had to stay at home for at least a week because their symptoms. 98% of individuals in the group had significant damage in social functioning. 74% of patients had impairment in academic or occupational functioning. 13% of affected individuals have been receiving government disability payments because of BDD.
• Risk of Suicide: A real risk of suicide has been observed, especially in women. 29% of the BDD attempt suicide at least once, 60% of this effort is due to BDD symptoms.

Relations with other disorders
People who have eating disorders like anorexia or bulimia are more likely to have a distorted body image. BDD test also show if other mental health disorders such as depression, anxiety disorder, and Body dysmorphic disorder statistics show if obsessive compulsive disorder is also more likely to be present with this dysmorphic syndrome.

Some patients who have low self confident with their appearance would have said yes to the question concerning the appearance, so kind of test like this without a psychiatrist may be very suggestion. In addition, a test like this may scare people, because if you majority said yes and rule based on the website it means you probably have body dysmorphic disorder, then you will fall on unwarranted fears. Consequently, you may be disturbed psychology and eventually you even really suffer for it.

Questionnaire test like this may have been effective, but is not recommended to be done alone, especially to admit the accuracy of the results. Do not believe it, because this types of somatoform disorder is a serious disorder that sometimes does not realize the symptoms and this disorder indistinguishable from regular appearances.

body dysmorphic disorder test

Some website which provide body dysmorphic disorder test, you can find in:

HealthyPlace.com: Body Dysmorphic Disorder in Children
Butler Hospital: Screening Questionnaire for Adults.
Butler Hospital: Screening Questionnaire for Adolescents.
Clayton Therapy: Body Image Test for Body Dysmorphic Disorder
Pamguide.com: Body Dysmorphic Self-Test

Wikipedia said if the severity of BDD was assessed using the Yale-Brown Obsessive Compulsive Scale  modified for BDD, and symptoms were assessed using a Body Dysmorphic Disorder Examination Sheet. Both tests were designed specifically to assess BDD. The results showed that BDD occurs in 0.7–1.1% of community samples and 2–13% of non-clinical samples. 13% of psychiatric inpatients were diagnosed with BDD. Some of the patients initially diagnosed with obsessive-compulsive disorder (OCD) had BDD, as well.

To get the accuracy body dysmorphic disorder test , besides read some  samples patient with body dysmorphic disorder, its better you find psychiatrist.

Not only lasts longer, physical complaints can not be predicted to cause, disrupting the lives of patients in a multidimensional side of live, so patients often feel stressed and depressed.

In addition, this new physical complaints can be referred to as symptoms of somatization disorder if it is a collection of specific physical symptoms. Meaning does not occur in isolation, but almost simultaneously. as described in the preceding pages, a collection of new physical phenomena could be referred to as symptoms of somatization disorder if it occurs:

• Four pain symptoms: a history of pain related to at least four different sites or functions (eg, head, abdomen, back, joints, extremities, chest, rectum, During menstruation, During sexual intercourse, or During urination)
• two gastrointestinal symptoms: a history of at least two gastrointestinal symptoms other than pain (eg, nausea, bloating, vomiting other than During pregnancy, diarrhea, or intolerance of Several different foods)
• one sexual symptom: a history of at least one sexual or reproductive symptom other than pain (eg, sexual indifference, erectile or ejaculatory dysfunction, irregular menses, excessive menstrual bleeding, vomiting throughout pregnancy)
• psuedoneurological one symptom: a history of at least one symptom or deficit suggesting a neurological condition not limited to pain (conversion symptoms Such as impaired coordination or balance, paralysis or localized weakness, difficulty swallowing or lump in throat, aphonia, urinary retention, hallucinations , loss of touch or pain sensation, double vision, blindness, deafness, seizures; Such symptoms as dissociative amnesia; or loss of consciousness other than Fainting)

Real form of physical symptoms encountered by patients with this kind of somatoform disorder can be:
• Abdominal pain
• Amnesia
• Back Pain
• bloating
• Chest pain
• Diarrhea
• Difficulty swallowing
• dizziness
• Headaches
• impotence
• Joint pain
• Nausea and vomiting Sometimes
• Pain During Intercourse
• Pain During urination
• Painful menstruation
• Pain in the legs or arms
• palpitations
• Paralysis or muscle weakness
• Sexual apathy
• Shortness of breath
• Vision changes

The most important part in explaining the variety of physical symptoms as somatization disorder symptoms are not made-up complaint or suggestion that patients develop physical symptoms if they was suffering from the above-mentioned purpose.

Those people who have BDD disorder is always dissatisfied with the condition of her face and body. Usually an area that often became the focus of attention is the nose, skin, and hair, eyes, eyelids, mouth, lips, jaw and chin shape. But other areas of the body can also be a problem and there is a tendency to focus on some particular body part or even faint; not clear which part in question. BDD disorders exhibit behaviour similar to eating disorders (eating disorder) in which the subject is a perfectionist. We will never see him quite well, although they underlined the midst of death (such as: cases of anorexia or underweight). These people have low self esteem so that they perceived physical shortcomings as a fatal failure.

Body Dysmorphic Disorder

Some samples patient with body dysmorphic disorder are:

Sample 1
Angel is a good girl. She has a sweet face. But somehow, she felt his nose less balanced. Every minute she is obliged to observe his nose in the mirror. She also refused to meet with people because they feel ugly. If necessary she will wear a mask to cover his condition. Plastic surgery was done and she was still not perfect. She was getting upset and attempting to commit suicide.

Sample 2
Already 2 hours Ellaide sitting in her dressing mirror, as if never satisfied with the makeup that has been removed several times. Ellaide is 15 years old, but very worried about her face, especially the skin and lips. Ellaide leather brown tan that actually makes her look sweet, but Ellaide not happy with the colour of her skin and she desperately wanted white skin glossy as the artist had seen on television. She had spent several whitening products, it still does not become a white skin as “guaranteed”, even change it often irritate the skin causing uneven patches. Many times she went to a dermatologist, to the salon or spa to whiten the skin, but it does not seem to bring results. Already a lot of money she spent for her appearance. Not to mention the complaints about the shape of the lips that he thought she was too wide and not very confident because of it. Ellaide often cover the lips with a handkerchief, especially if you’re talking to someone. She does not want people to pay attention to her lips.

Body Dysmorphic Disorder

Sample 3
Mandy (25 years old) is always complaining about his shortcomings. She was often in the gym locker room for reflection. With exaggerated fears she told everyone how his body is plump and compare with other people’s bodies. In fact, Mandy body petite and slim. Everyone was so admire him. To address these complaints, Mandy always work out and come to the gym.

With these all cases, we can conclusion if self confident has close relation with this body dysmorphic disorder (BDD.

General definition of hypochondriacs is a condition which  someone believe on realistic fears if they are suffering from some serious illness (preoccupation) so they seek professional treatment continuously, taking several medications over-the-counter, although no medical basis can be found to explain the  physical symptoms. But sometimes people do not understand much about the disorder because the hypochondriac symptoms very similar to anxiety. For easier recognize, here are some examples of cases that have occurred in society.

Hypochondriac Symptoms

Case I
Andy, he ever has tumor in his arm. Doctors had successfully removed the tumor but his focus on the tumor not stopped. He has always subscribed to magazines to review many of the tumors. One time, he reads an article about brain tumors and then he felt if he was suffering from the symptom of tumor that he has been read. He immediately went to the doctor to check it because he experienced the same symptoms as listed in the magazine. But the doctor said there was no tumor in his brain. But he remains convinced that he was suffering the disease so every two months once he checked his health with medical assistance, though the results said he was healthy.

Case II:
A young boy is very fond of his father. His father suffered severe of pain and then his father died. After that, the young boy feels if he suffers a similar pain with his father. He began to feel the symptom of disorder one by one and then he immediately went to see medical specialists. But medical experts did not find any disease or disorder on his body. He is repeatedly to go to other medical experts and even change the doctors. But the results remain the same. He is okay.

Hypochondriac symptoms

Case III:
One of band’s vocalists has fired from his band with no apparent reason. He is very hurt because he was the spirit of enthusiasm on stage and the band will be on recording two more weeks. At home, the vocalist was confused what to do at 07-10 at night, because he was usually training together with his band on that hour. He doesn’t tell anyone so when his friend, girl friend and father ask about it, he feel depressed. He feels any pain like pain in his spine. One day, he read health magazine and find about osteoporosis. He suddenly believes if he suffers this disorder and come to some doctor. He did all the examination such as check lab. But all the result says if he is healthy.

Some of these case show if the patient has the similar symptom. They like read healthy magazine and fix the symptom that they read with their condition. They also believe if they suffer at least one seriously disease or disorder and never accept the examination result. And the important thing, the always wary and sensitive to signs of new disease. These all are hypochondriac symptoms.

People who suffer from somatoform disorders much more frequently come to the doctor than to a psychiatrist or psychologist because they consider issues related to physical condition. The patients consider referral to a psychologist or psychiatrist as a sign that doctors considered their disease “is located in the head”; so they do not feel happy to be referred to a “psychiatrist”. They test the patience of their physicians, who often prescribe various drugs or medical treatment in hopes of curing these somatic complaints.

Healing with a speech which became the basis of psychoanalysis is based on the assumption that a massive repressive force of psychic energy has been converted into a confusing anesthesia or paralysis. However, traditional psychoanalysis with long-term therapy and psychoanalytic-oriented psychotherapy showed no beneficial results for conversion disorder, except perhaps to reduce patient anxiety over their illness. Handling short-term psychodynamic can be effective as somatoform disorder treatment to relieving symptoms of somatoform disorders.

Somatoform Disorder Treatment

Somatoform patients often suffer from anxiety and depression. With the handle of anxiety and depression often reduces anxiety somatoform. In the case of comorbidity between obsessive compulsive disorder and somatoform disorders, such as hypochondria and body dysmorphic disorder, treatment option for-compulsive disorder and exposure-response prevention can be effective for these somatoform disorders. Therapist need to take and ensure the patient does not lose face when the disturbance is no longer experienced. The therapist should consider the possibility of the patient to feel humiliated when their condition better trough unrelated to medical problems (physical) handling.

somatoform disorder treatment

Therapy for somatization disorder

1. Exposure or cognitive therapy can be used to overcome the fear, reduce of the fear can help reduce a variety of somatic complaints.
2. Family therapy, helping patients and families to change the network relationship that aims to help business become more independent.
3. Training assertion and social skills, useful for helping patients control or repossess, a variety of ways to relate to others and overcome the challenges without having to say “I am a poor, weak and sick.”
4. Doctors do not avoid the validity of physical complaints, but minimize the use of various diagnostic tests and drug delivery, maintaining contact with patients. Techniques such as relaxation training and other forms of cognitive therapy also proved useful. Biofeedback, which covers the control of physiological processes, has been proven effective in reducing the various thoughts that damage in patients suffering from somatoform disorders – even more effective than relaxation techniques

Therapy for hypochondria.

1. Cognitive behavioral approach. Research shows that patients hypochondria show with cognitive storage with consider if the health problems that appear as a threat. Cognitive-behavioral therapy can be directed to restructure such pessimistic thoughts.
2. Handling can encompasses several strategies such as selective attention directing patients to physical symptoms and do not encourage patients seek medical certainty that he was not sick.

Therapy for Somatoform pain disorder
1. Pain contains two components, namely psychogenic pain and pain are actually caused by medical factors, such as muscle tissue injury. Effective treatment tends to consist of the following things

• Validate that the pain is real, and not only in the mind of the patient.
• Relaxation training.
• Rewarding because patients who do not behave in line with pain (withstand the pain).

2. A variant of short-term psychodynamic therapy, which is called psychodynamic body therapy, is effective to reduce pain and maintain it in the long term.

3. Low-dose antidepressants, especially imipramine, higher benefit than placebo for reducing pain and chronic distress. These drugs do not eliminate the depression-related.

4. In general, seem to have suggested to divert focus from the things that can not be performed because the patient’s illness and even teach patients how to cope with stress, encourage more activity, and increase self-control, regardless of physical limitations or discomfort experienced by patients. This makes the therapy for the somatoform disorder treatment works.

They can spend hours to see the mirror and take extreme measures to try to correct the perceived damage, such as needless plastic surgery, withdrawing socially, or even sit at home alone, until the suicidal thoughts. This has led to decline in many functions of a person’s life, such as social functioning, employment, academic and communication.

Body Dysmorphic Disorder Symptoms
A person may experience body dysmorphic disorder symptoms gradually or suddenly. The focus of appearance that makes sufferers of stress is generally lower and the head although some patients also have problems in other parts of the body such as thinning hair, scars, skin colour, signs of blood vessels or the problem of wrinkles.

BDD disorder

People with body dysmorphic disorder often show a pattern of dress up or wash, or hair compulsively in order to correct the perceived damage. Another example, a person feels his face like a plate, too flat, so it does not want to be photographed. They can do anything to fix the broken state.

In body dysmorphic disorder, patients covered by the shadow of the deficiencies in their physical appearance, making them look in the mirror can linger in front of the mirror looking at body shape that is considered less. Patients also often come to surgery and beauty specialist.

More extreme action makes people only venture out at night to avoid people.

Epidemiology
Appears mostly in women who typically focus on the hair, face and breast. In men, the focus of obsession with BDD disorder is usually on the genitals and muscle problems. Obsession with BDD usually begins in late adolescence, and is usually associated with depression, social phobia, and personality disorders. About 1% occupation of the United States suffers from BDD disorder while the percentage increased to 6-15% for the entire population of the world. BDD can lead to suicide patients, especially in women.

Body Dysmorphic Disorder Test
Based on DSM IV body dysmorphic disorder, diagnostic criteria and test for body dysmorphic disorder:
1) Preoccupies with shadow defect in appearance. If found slightly anomalous body, the person fears become excessive.
2) Preoccupies cause clinically significant suffering or disturbance in social functioning, employment, or other important functions.
3) Preoccupies can not be explained better by another mental disorder (e.g., dissatisfaction with body shape and size in anorexia nervosa).

Body Dysmorphic Disorder Treatment
Generaly, treatment of somatoform disorders has same combination on treatment in patients with body dysmorpic disorder, which is has same aims to:
1. Prevent the adoption of the pain, invalidism (not justify thinking / convinced that the phenomenon exists only in the mind is not for real life)
2. Minimize costs and avoid complications with test diagnosis, treatment, and medicines that do not need
3. Pharmacological control of comorbid syndromes (aggravating the condition)

Body dysmorpic disorder treatment combines methods of psychotherapy, psychosocial and pharmacological.

Pharmacological
An experiment showed that serotonin reuptake inhibitors or SSRIs shown to reduce symptoms in patients with BDB. SSRI are antidepressants that reduce and obsessive compulsive behaviour, proven to reduce symptoms of somatoform disorder. Another treatment is also monoamine oxidase inhibitors by using, tricyclic antidepressants and pimozide.

Psychotherapy
Psychotherapy for BDD disorder use of cognitive behavioural therapy. This therapy can assist patients in changing their false belief on performance and stop the compulsive behaviour in a hide or disguise the physical disability that is believed to exist, such as stop doing cosmetic surgery.

Psychotherapy conducted by the same physician with a consistent treatment.

Strategies and techniques of psychotherapy and psychosocial
1) Treatment consistent, handled by the same physician
2) Create a regular schedule with adequate time intervals of arrival
3) Focus on treatment of symptoms gradually to the personal and social problem.

In pain disorder somatoform disorder, patients suffer pain in one or more parts of the body such as waist, sciatic, pelvic, head, face, chest, joints, bones, stomach, breast, kidney, ears, eyes, throat, teeth, and urine. Pain in somatoform pain disorder is associated with two factors, psychological factors and general medical conditions that have an important role in the onset, severity, exacerbation or maintenance of pain. But if the psychological factors already present, then this common condition does not play a role in the severity of the exacerbation or maintenance of pain onset.

Pain disorder mostly affects on women and the causes can not be found medically. Pain can arise suddenly, usually comes after suffering from stress and can last for several days or even years. Pain is usually accompanied by an organic disease, but the presence of this disease can not adequately explain the severity of pain.

pain disorder

Differences of somatoform pain disorder and ordinary pain are due to physical disturbance. If the ordinary pain, patient can indicate the location of pain with very specific and detail. In addition, patients could also explain the picture of pain experienced (sensory) and also could explain whether the condition has improved or deteriorated after an action. The opposite occurred in patients with somatoform pain disorder, they could not explain the ocation of pain, hard to explain and can not feel if the pain is reduce or deteriorate.

History of Somatoform Pain Disorder
Patients with pain disorder somatoform disorder usually have frequently visited the doctor for diagnosis and treatment. This disorders can strike human at any age, but usually begin during adolescence and young adults.

Impaired pain can appear suddenly and the pain can drastically increased  for a few days to weekly. Pain also can be lost suddenly. Treatment is effective to eliminate it, although doesn’t rule out the possibility that the disorder becomes chronic pain despite treatment.

Causes of pain disorders
The cause of this disorder is psychological problem. In the past, the disorder is associated with emotional stress and until now many people who are stress was experiencing pain in certain body parts. But the pain which is caused by normal stress differs with somatoform pain disorders. In somatoform pain disorder, patients feel severe pain and the severity will increase. The condition also can be exacerbated by concerns over the condition and its makes people difficult to rest.

Somatoform Pain Disorder Symptoms
The main symptom of pain disorder is severe pain which can’t be explained by patients with motor sensations. The cause also can’t be explained by any medical illness. Pain may occur at any body part such as the waist, sciatic, pelvic, head, face, chest, joints, bones, stomach, breast, kidney, ears, eyes, throat, teeth, and urinary.

Case Illustration
A 32-year-old unemployed man, who is in a state of fear and shortness of breath, was taken to the emergency room. He also complained of severe pain in the chest area. The doctor do the examination. The result of vital signs and electrocardiogram were on normal condition. But this guy kept complaining if he suffered severe pain and requested an injection of Demerol. Doctors finally gave intramuscular meperidine 75 and the patient feels the better condition.

Patient has  complex family history. There is a strong history of heart disease in the family and the patient’s father died suddenly by acute myocardial infarction. The first episode of chest pain is occurred by patient 1 year later, when he woke up from sleep in the night before he was scheduled to appear in court. Since the first attack,  he experiences chest pain attacks continually, usually requiring narcotic analgesia for help, about twice a month and sometimes as often as three to four times a week. There is no organic disease when patient occur test.

Epidemiology
Prevalence of pain disorder somatoform disorder is unknown, but the disorder seems common in general medical practice. Occurred at all age levels, 10-15% of USA patients present this disorder with complaints of back pain. Pain disorder is more common in women than men. Familial distribution has not been reported. Depression and alcohol abuse may be common in families of patients.
People with physical or sexual violence history in the past are more likely to suffer this disorder, but the history of abuse are not always owned by people with somatoform pain disorder.

Diagnostic Criteria
Diagnostic criteria for somatoform pain disorder based on DSM IV pain disorder are:
1. The main complaint was severe pain, torture and settled, which can’t be explained entirely on the basis of physiological processes and physical disturbance.
2.  Pain may arise if there is an emotional conflict or psychosocial problems which are quite obvious. It can be an obvious reason for the cause of the disorder.
3. A complaint has resulted in increased attention and support, both personal and relevant medical patients.

Exams and Tests
To diagnose somatoform pain disorder, the patient should perform overall medical evaluation. Medical evaluation is also combined with laboratory tests and scans radiologist (MRI, CT, ultrasound, x-ray) to detect the possibility of pain from organs dysfunction.
The ability of the patient in explaining the source of pain, pain location and the description of the perceived pain can also be a basis for diagnosis. If the patient can’t give an explanation about these factors, the pain could be somatoform pain disorder.

Pain Disorder Treatment
In recent years, there has been interest and advancement in the treatment of somatoform disorders, especially pain disorder treatment. Many studies show multidisciplinary approach (involving a neurologist, internist, and anaesthesiologist other than psychiatrists) for the management of pain in inpatient settings, including treatment with psychotropic drugs such as antidepressants, can be effective in achieving relief from pain and improve depression symptoms. The relationship between chronic pain and depression is unclear.
Pain disorder treatment can be done by combining medication with psychotherapy.

Psychotherapy
For psychotherapy, most patients with pain disorders can be treated with cognitive behavioural therapy (CBT). This therapy can relieve pain during the therapy, the patient will be able to learn the cause of pain and how the pain is getting worst. Patine also can overcome the sensation of pain which is felt on the body and remain become active and more active  even although they still feel pain.
Pain disorder treatment also can be done through support groups such as family and friends.

Pharmacological
Antidepressant medication can help to  relieve pain, although it’s very rarely to works well and also can cause side effects. Treatment with the drug should be controlled so as not to aggravate the condition and should be avoided if the nature of addiction.

Acetaminophen and NSAIDs (not mixed) or as an adjunct to opioids is also can be used for acute pain. For chronic pain, doctor can use tricyclic antidepressants, acetaminophen and NSAIDs. Drugs should be given in accordance with a prescription.
Patients can also consider acupuncture for relaxation.

According to DSM IV, conversion symptoms like neurological or general medical condition that involves various problems with the voluntary motor function or sensory function. Some patterns of symptoms associated with conversion of the classic symptoms of paralysis, epilepsy, coordination problems, blindness, and tunnel vision (only could see what was directly in front of the eye), loss of sense of hearing or smell, or loss of feeling in limbs (anesthesia). A physical symptom of the body which was found in conversion disorder is often not in accordance with medical conditions which  have been connected previously. For example, the conversion of epilepsy, epilepsy patients do not like the truth, the patient can maintain control at the disposal of relapse. In the conversion of blindness, the patients could even walk to the doctor without touching the furniture.

Etiology
The theory that explains conversion disorder causes is explained by the theory of psycho analysis and behavioral theories.

Psychoanalytic Theory
(1895/1982), Breuer and Freud: Conversion disorder is caused when a person experiences events that cause a large increase in emotion, but its effects can’t be expressed and memories of the event are removed from consciousness

Behavioral theory
Ullman & Krasner (in Davidson, Neale, Kring, 2004), conversion disorder occurs because the individual adopts a symptom to achieve a goal. Individuals strive to behave in accordance with their views on how a person with a disease will affects motor skills or sensory as they will react.

Epidemiology

conversion disorder

in nineteenth century, more women suffer from conversion disorder. While in the 20th century, more conversions suffered by men as battle casualties during world war is checked, there were many who experienced conversion. According to the DSM-IV report, conversion disorder rate increased from 10/100, 000 to 300/100, 000 was found in the general population sample and it is stated that conversion symptoms have been reported as the focus of treatment in 1-3% of referrals to outpatient mental health clinic.
Conversion disorders usually occur at children age (end) until adulthood (early). This disorder rarely occurs before age 10 years and after 35 years.

Conversion Disorder Symptoms
Conversion disorder DSM IV criteria:
A.  At least there is one symptom or deficit voluntary involving motor function or sensory function that indicates a physical disorder.
B. Assessed psychological factors associated with the disorder because of the onset or recurrence of physical symptoms related with its emergence.
C. That person does not intentionally create these physical symptoms, or pretends to have it with a specific purpose.
D. Symptoms can not be explained as a cultural ritual or pattern of response, nor can it be explained by any physical disturbance through a proper test platform.
E. Symptoms can cause significant emotional distress and affect one or more areas of functional area such as social or work function, which in turn require a medical examination.
F. Symptoms are not limited to complaints of pain or problems with sexual function, nor can it be caused by other mental disorders. Some people with conversion disorder often showed a surprising indifference to current symptoms, this phenomenon is known as la belle indifference (ignorance is beautiful).

This type of symptom or deficit in this conversion disorder can be divided into 4:
-By symptom or motor deficit
-With sensory symptom or deficit
-With seizures or convulsions
-With mixed picture

As symptoms of physical disorder occurs in somatization disorder disorder, conversion disorder symptoms might also become very disturbing and may put individuals in risky conditions. This risk can become complication occurs in a medical or surgical treatment is not necessary and the risk of excessive costs.

Conversion Disorder Diagnosis:
Differential diagnosis is a diagnosis of somatic disease. Somatic illness in the form of psychological disorder, leads to the emergence of another diagnosis of a disease on patients because of complaints suffered by them who come with somatic disease are  similar to patients with common diseases.

When a somatic disorder can’t be identified, a diagnosis of conversion disorder should not be made unless there is clear evidence that the symptoms serve a psychological function. Conversion symptoms can occur as one component of somatization disorder. When this happens, the diagnosis of conversion disorder is not done yet. Conversion disorder is common in patients with dissociative  identity disorder, sometimes in condition that occur in patients with schizophrenia.

Case Illustration
A woman aged 47 years; married was in the room psychiatric consultation unit. She believed that she had an accident. He fainted at his home and was taken to hospital for treatment of paralysis which occurs at the right side of  her  body. On examination, her right arm and right leg has a normal reflex. All other aspects of the neurological examination were also normal. Patients seemed indifferent to the conditions and difficulties and can chat quietly with fellow staff and patients.

Laboratory studies, CT scans and MRI also show normal results.
Patients expressed a series of brutal argument between husband and son. The second oldest child victims evicted from home by their father after a physical conflict occurred repeatedly. The same pattern seems to be repeated on the youngest child. Patients, although describing that he was never angry, vows that he will not let her husband drive her youngest child.

But a series of conflicts occurred, and her husband was threatened to physically assault against their youngest child. One night, the patient discovered that her husband and children were involved physical fights. As she felt anger and fear, the patient struck with her own thoughts that she felt hate them and thus be wanted to drive them out. At that time, the patient suddenly felt weak in her right arm and fell to the floor.

The woman turned out to have two episodes of conversion symptoms in the context of the same family conflict. He describes a childhood history of physical violence, witnessing  family violence and neglected.

Conversion disorder treatment
The aims of conversion disorder treatment are:
1) Prevent the pain’s adoption,  invalid  (make sure that the symptoms happen in mind and not only in real life.
2) Minimize the costs and avoid complications by conducting diagnosis tests, treatments, and and avoid unnecessary drugs.
3) Conducting pharmacological control of comorbid syndromes (aggravating the condition)

Effectiveness of pharmacological interventions to alleviate symptoms of conversion disorder has not been proven, so it is seldom recommended in the treatment of conversion disorder. Most patients treated with a special psychotherapy, such as behavioral therapy and hypnosis.

These conversion symptoms often spontaneously disappear although sometime it may recur. If symptoms do not disappear and frequent relapse, then you should ask for treatment. A variety of effective treatments to overcome this conversion disorder symptoms are:

Counseling (psychotherapy).
Psychologist or professional counselor can help you deals with anxiety, depression or even mental health problems. In addition, psychotherapy can also prevent the symptoms reoccur.

Physical Therapy

It can be done by doing by physical activity like working. The routine movement of arms or legs can prevent muscle tightness and weakness. This therapy can prevent complications of certain conversion symptoms.

Treating stress and other related conditions
Conversion disorder may help you to  get treatment for stress, anxiety or another underlying problems. Your Doctor May prescribe anti-anxiety medications, antidepressants or other drugs as part of your treatment plans, depending on your personal health profile.

Hypnotic
Hypnosis is usually combined with other psychotherapy on treatment of somatoform disorders. By following this therapy conducted by by experts  patients will be assisted in dealing with other psychological problems.

Transcranial Magnetic Stimulation
this exciting treatment involves weak elextrical currents to check the brain activity. This stimulation is believed to alter the brain’s biochemistry and  improve various symptoms of mental disorders.

Strategies and techniques of psychotherapy and psychosocial:
1. Conduct consistent treatment, handled by the same physician
2. Create a regular schedule with an adequate time intervals of arrival
3. Focus on treatment of symptoms gradually to the personal and social problem
4. Acute: convincing, suggestion patients to reduce symptoms
5. Consider narcoanalisis (sedative hypnotics), hypnotherapy, and behavioral therapy.
6. Chronic: further exploration of the interpersonal conflict in patients

Although pharmacology is not effective in the treatment of conversion disorder, but the treatment would be necessary, especially in treating some symptoms. Strategies and techniques and physical pharmacological:
1. Only given a clear indication
2. Avoid drugs that are addiction
3. Consider narcoanalisis (sedative hypnotics). Prognosis would be considered good, if the initial onset of precipitation showing a clear factor, if the intelligence is still good, conduct immediate treatment.It would be considered poor prognosis if it happens otherwise.