Criteria

Diagnostic and statistical manual of mental disorders, 5th ed, text revision (DSM-5-TR) criteria for the diagnosis of functional neurological (symptom) disorder (conversion disorder)[2]

A. The patient has ≥1 symptoms of altered voluntary motor or sensory function.

B. Clinical findings provide evidence of incompatibility between the symptom and recognised neurological or medical conditions.

C. The symptom or deficit is not better explained by another medical or mental disorder.

D. The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or warrants medical evaluation.

Specify type of symptom or deficit as:

  • With weakness or paralysis

  • With abnormal movement (e.g., tremor, dystonic movement, myoclonus, gait disorder)

  • With swallowing symptoms

  • With speech symptoms (e.g., dysphonia, slurred speech)

  • With attacks or seizures

  • With anaesthesia or sensory loss

  • With special sensory symptom (e.g., visual, olfactory,or hearing disturbance)

  • With mixed symptoms.

Specify if:

  • Acute episode: symptoms present for less than 6 months

  • Persistent: symptoms present for 6 months or more.

Specify if:

  • With psychological stressor (specify stressor)

  • Without psychological stressor.

DSM-5-TR criteria for the diagnosis of somatic symptom disorder[2]

A. The patient has one or more somatic symptoms that are distressing or result in significant disruption of daily life.

B. Excessive thoughts, feelings, or behaviours related to the somatic symptoms or associated health concerns as manifested by at least one of the following:

  1. Disproportionate and persistent thoughts about the seriousness of one's symptoms

  2. Persistently high levels of anxiety about health or symptoms

  3. Excessive time and energy devoted to these symptoms or health concerns.

C. Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months).

Specify if

  • With predominant pain (previously pain disorder): this specifier is for individuals whose somatic symptoms predominantly involve pain.

Specify if

  • Persistent: a persistent course is characterised by severe symptoms, marked impairment, and long duration (more than 6 months).

Specify current severity

  • Mild: only one of the symptoms in criterion B is fulfilled.

  • Moderate: two or more of the symptoms specified in criterion B are fulfilled.

  • Severe: two or more of the symptoms specified in criterion B are fulfilled. Plus there are multiple somatic complaints (or one very severe somatic symptom).

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