CONVERSION DISORDER Do you believe that your mom’s condition is mainly
precipitating it?
Psychotic Questions:
Ever see or hear voices when other people can’t?
Any strange feeling on the skin (tactile)
Any strange experience when you sleep or upon walking
up? (Htpnogogic/ hypnopumpic)
Nightmares? Strong smell?
Thought Content
Do you think people want to harm you?
Is there anyone who is trying to influence you?
Is there anything you can’t get rid out of your mind?
Do you ever feel that the TV is talking to you or about you?
Do you think you have special powers?
Do you think people can read your mind?
MOOD questions
How do you feel?
How is your spirit?
What is your pattern of sleep?
Anhedonia – sex and other activities +Social
Appetite?
Suicidal ideation? Still interested in life or not?
Have energy to live?
Do you think life is still worth living?
Do yo want to harm yourself?
Do you have plans or have planned to commit suicide?
Judgment
If you find a sealed envelope with stamp, address what will
you do?
If there is any fire in the room what will you do?
Do you think you need any help?
What’s your plan for the future?
I understand what you are feeling – about your mom’s
condition
I am really sorry about your condition
I know you lost your voice but I need to ask some
questions
You can understand by nodding your head
Has this happened before? (The lost of voice)
Any cough or hoarseness of voice before?
Can you make any sound? Or can you cough for me?
Do you feel any lump in the throat that makes it difficult to
talk
Do you have any surgery of running nose or flu recently
Do you feel anxious of your mom’s pain and condition and
you can’t tell
Are you feeling with your family now? Any problem there?
Are you studying or working?
How is your mood now?
Do you feel low or guilty?
Can you sleep? Or your mom’s condition interrupt your
sleep?
Recently, did you lose your interest in what you used to
do?
 other mood, thought and judgment questions
Any headache? Abdominal pain? Any systemic diseases?
SAD
Do you think you need help?
If there is fire in the hospital right now, what will you do?
I would like to ask examiner about
ENT – throat tonsil, larynx, nose, ear
Rapidly check other systems
Stress Reaction
According to history and physical examination your recent
loss of voice is most likely related to your mother’s
condition and the stressful environment that you recently
experienced.
In medical terms, it is called Conversion Disorder.
This condition happened when our mind is over stressed
by surrounding problem
Our brain and mind is connected together so our body
reacts.
Normally, we have some stresses and anxiety but we can
manage it without body response.
But in severe cases, the body response and in your case
your lost your voice.
It has a good prognosis
I need to refer you to ENT specialist to examine you
thoroughly and confirm the diagnosis
I can arrange a family meeting if you want to do so and we
can discuss about it.
I can arrange to contact oncologist who can give you
higher dose of painkiller for your mother’s pain
And then we’ll refer you for counselor who can help you
with this condition by certain methods like Cognitive
Behaviour Therapy
If not responding well, we can refer you to psychologist
Good prognosis if
sudden onset,
clear identifiable stress,
above average questions
Symptoms of paralysis, blindness and aphonia has good
prognosis
Bad prognosis:
1. comorbid mental
2. seizure/ conversion tremor