Conversion disorders in childhood and adolescence

Since its first definition 100 years ago, the term conversion underwent many changes, a fact that is proved by various re-evaluations with respect to classification (DSM-IV, ICD-10). In the context of a psychodynamically-oriented diagnostic there are - in addition to that - actual attempts to reach a valid operationalization of the conversion concept. From a psychodynamic point of view a differentiation of traditional concepts has been made. Results of examinations of 45 children and adolescents (average age: 14 years, range: 8-18 years) who had been treated in the Department of Child and Adolescent Psychiatry of the University of Essen for conversion symptoms, revealed a strong interaction of oedipal and pre-oedipal conflicts and that in case that there was no help from a third object during early triangulation, the child's endeavor to break out of the primordial relationship with the primary love object had been impeded and thus individuation processes were impaired or even prevented. Our results lead to the conclusion that for the young patients, who came to us with a conversion symptom, the early pre-oedipal triangulation failed and thus primary separation and dependecy conflicts could not be solved adequately.