Behaviour therapy in a case of hysterical blindness
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We present the case of a patient having dissociative identity disorder DID who-after 15 years of misdiagnosed cortical blindness--step-by-step regained sight during psychotherapeutic treatment. At first only a few personality states regained vision whereas others remained blind. This could be confirmed by electrophysiological measurement, in which visual evoked potentials VEPs were absent in the blind personality states but were normal and stable in the seeing states. A switch between these states could happen within seconds. We assume a top-down modulation of activity in the primary visual pathway as a neural basis of such psychogenic blindness, possibly at the level of the thalamus.
Somatoform disorders are characterized by physical symptoms suggesting medical disease but without demonstrable organic pathology or a known pathophysiological mechanism to account for them. Learn about the nursing management for somatoform disorders in this nursing care plan guide. Prevalence rates for the most restrictive previous diagnosis of somatoform disorder appear low in community samples 0. If indicated, specific studies used to rule out somatization due to general medical conditions include the following:.
Conversion disorder CD , or functional neurologic symptom disorder , is a diagnostic category used in some psychiatric classification systems. It is sometimes applied to patients who present with neurological symptoms, such as numbness , blindness , paralysis , or fits , which are not consistent with a well-established organic cause, which cause significant distress, and can be traced back to a psychological trigger. It is thought that these symptoms arise in response to stressful situations affecting a patient's mental health or an ongoing mental health condition such as depression. Conversion disorder was retained in DSM-5 , but given the subtitle functional neurological symptom disorder. The new criteria cover the same range of symptoms, but remove the requirements for a psychological stressor to be present and for feigning to be disproved.