Diagnosis

The diagnosis of hysteria may be difficult, especially as such symptoms may be associated with genuine organic illness.

Consider the following points when making a diagnosis of conversion or dissociative syndromes:

• an organic diagnosis should be excluded on the basis of the history or subsequent investigations
  
  
• there should be evidence of underlying emotional stress - this often takes the nature of a conflict situation
  
  
• an appropriate time relationship between the onset of the symptom and the stress
  
  
• the symptom has often been experienced before, either by the patient or by a person close to the patient
  
  
• a history of previous transient stress reactions

Also the diagnosis may be supported by:

• a clear symbolic meaning of the symptom itself.
• the course of the symptoms in response to treatment.

Note that it is important to remember that physical illness may accompanied by hysterical symptoms and conversely that patients with histories of hysteria may subsequently present with organic illness.