Il disturbo di conversione è una condizione di salute mentale in cui una persona può sviluppare una serie di sintomi caratteristici di deficit neurologici o sensoriali che non possono essere spiegati con una malattia organica, in quanto esclusa da test diagnostici specifici. In genere ad esempio si manifesta con un blocco (parziale o totale) di alcune funzioni come la vista, l’udito o la possibilità di camminare. Un esempio può essere la paralisi di una gamba o la cecità dopo un incidente, laddove non vi siano lesioni fisiche riscontrate. Scopriamone insieme i dettagli, come fare la diagnosi ed avviare una terapia corretta.
Cause e sintomi del disturbo di conversione
I sintomi di questo disturbo noto anche come isteria di conversione si ritiene che siano scatenati da un conflitto psicologico. Iniziano solitamente all’improvviso, come conseguenza, apparentemente diretta di un’esperienza stressante. Maggiormente a rischio, gli individui che hanno una patologia neurologica o un altro problema di salute mentale come il disturbo dissociativo o un disturbo della personalità. I sintomi non sono simulati intenzionalmente, ma drammaticamente vissuti come reali da chi li subisce e non sono controllabili.
I più comuni includono la perdita di una o più funzioni corporee, quali:
- Cecità o disturbi visivi imponenti come vedere doppio
- Incapacità di parlare (mutismo)
- Intorpidimento
- Paralisi
- Un sintomo debilitante che inizia improvvisamente
- Storia di un problema psicologico che migliora dopo la comparsa del sintomo
- La mancanza di preoccupazione che di solito si verifica con un sintomo grave
Quando vedere un medico e diagnosi
E ‘ chiaro che alla comparsa di sintomi di questo tipo ci si rivolge direttamente al proprio medico curante o ad uno specialista di quella che è la problematica riscontrata (in caso di cecità o visione doppia ad esempio un oculista). I test diagnostici saranno avviati per individuare la causa fisica e attivare la terapia del caso. Quando non si trova nulla si arriva al sospetto di disturbo di conversione. Ma come si fa la diagnosi certa? Solitamente si viene inviati da un neurologo, da uno psichiatra o neuropsichiatra.
Per essere diagnosticati con disturbo di conversione, è necessario soddisfare i criteri del Manuale Diagnostico e Statistico dei Disturbi Mentali (DSM). Questo manuale è frutto del lavoro della American Psychiatric Association, ma i suoi principi sono riconosciuti come validi in tutto il mondo e base di riferimento.
Per avere una diagnosi di disturbo di conversione dunque, secondo il DSM, occorre rispondere alle seguenti caratteristiche patologiche:
- È necessario disporre di uno o più sintomi, non controllabili o volontari, che influenzano il movimento del corpo o i sensi, che non possono essere spiegati da una condizione medica neurologica o altro.
- I sintomi possono essere correlati a un evento stressante o un trauma, sia fisico che psicologico, anche se non sempre questo è identificabile facilmente come tale.
- I sintomi non sono prodotti dal paziente in modo volontario e non ottiene benefici di alcun tipo dai sintomi stessi.
- I disturbi non sono completamente spiegati da una condizione medica generale, l’uso di droghe o di un comportamento culturalmente accettato, come ad esempio un’esperienza in un rituale religioso.
- I sintomi devono causare notevole stress o difficoltà nella vita sociale, lavoro o altro.
- I sintomi non sono meglio giustificati da un altro problema di salute mentale. In questo caso, test psicologici devono essere richiesti da uno specialista della salute mentale.
Non ci sono test standard per verificare la presenza di disturbo di conversione. Le indagini diagnostiche dipenderanno dalla sintomatologia e richiederanno raggi x o altre analisi di imaging, un EEG (Elettroencefalogramma) o semplici test funzionali come quello dei riflessi.
La diagnosi è difficile perché le patologie da escludere che possono dare origine alla medesima sintomatologia sono molte ed estremamente diverse tra loro. Ad esempio le seguenti:
• Miastenia grave, che provoca debolezza muscolare
• Sindrome di Guillain-Barre – una malattia rara in cui il sistema immunitario del corpo attacca i nervi
• Disturbi neurologici – malattia di Parkinson e l’epilessia
• ictus
• Lupus
• Lesioni del midollo spinale
• HIV / AIDS
Potrebbero interessarvi anche i seguenti post:
Disturbo di conversione, sintomi e cause
Disturbo di somatizzazione, cause, sintomi, cure
Ridurre stress e ansia con la fitoterapia
Fonte: Mayo Clinic
Foto: Thinkstock
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