. Author manuscript; available in PMC: 2012 Mar 1.

Published in final edited form as: Psychosomatics. 2011 Mar–Apr;52(2):109–116. doi: 10.1016/j.psym.2010.12.017

Table 1.

Comparison of diagnostic criteria from the psychiatric and neurologic perspectives

DSM-IV-TR Diagnostic Criteria for “Conversion disorder, with motor symptom or deficit”	Neurologic Categories of Diagnostic Certainty for “Psychogenic movement disorder” (adopted from Williams, 1995)¹⁹
One or more symptoms or deficits affecting voluntary motor function that suggest a neurological condition. Psychological factors are judged to be associated with the symptom or deficit because the initiation or exacerbation of the symptom or deficit is preceded by conflicts or other stressors. The symptom or deficit is not intentionally produced or feigned. The symptom or deficit, after appropriate investigation, is not fully explained by a general medical condition, or by the direct effects of a substance, or as a culturally sanctioned behavior or experience. The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or warrants medical evaluation. The symptom or deficit is not limited to pain or sexual dysfunction, does not occur exclusively during the course of Somatization Disorder, and is not better account for by another mental disorder.	Documented psychogenic movement disorder: persistently relieved by psychotherapy, suggestion, or placebo; movements abate when patient is unaware of being observed (although this may be present in malingering or factitious disorder) Clinically established psychogenic movement disorder: movements are inconsistent over time or incongruent with clinical presentation of an organic movement disorder; this may be supported by the presence of other definitely psychogenic signs (false weakness, false sensory findings, self-inflicted injuries), multiple somatizations, or an obvious psychogenic disturbance Probable psychogenic movement disorder: 1) patients in whom movements are inconsistent or incongruent with an organic movement disorder but in whom there are no other features to provide support for the psychogenic diagnosis; 2) patients in whom abnormal movements are consistent and congruent with an organic movement disorder, but in whom other definitely psychogenic physical signs are present (see above); 3) patients in whom the movements are consistent and congruent with an organic movement disorder, but in whom multiple somatizations are present Possible psychogenic movement disorder: suspected if an obvious psychiatric disturbance is present in a patient with abnormal movements that are consistent and congruent with an organic movement disorder; may have inappropriate affect, discrepancy between movement disorder and reported disability, or presence of secondary gain

DSM-IV-TR Diagnostic Criteria for “Conversion disorder, with motor symptom or deficit”

Neurologic Categories of Diagnostic Certainty for “Psychogenic movement disorder” (adopted from Williams, 1995)¹⁹

One or more symptoms or deficits affecting voluntary motor function that suggest a neurological condition.
Psychological factors are judged to be associated with the symptom or deficit because the initiation or exacerbation of the symptom or deficit is preceded by conflicts or other stressors.
The symptom or deficit is not intentionally produced or feigned.
The symptom or deficit, after appropriate investigation, is not fully explained by a general medical condition, or by the direct effects of a substance, or as a culturally sanctioned behavior or experience.
The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or warrants medical evaluation.
The symptom or deficit is not limited to pain or sexual dysfunction, does not occur exclusively during the course of Somatization Disorder, and is not better account for by another mental disorder.

Documented psychogenic movement disorder: persistently relieved by psychotherapy, suggestion, or placebo; movements abate when patient is unaware of being observed (although this may be present in malingering or factitious disorder)
Clinically established psychogenic movement disorder: movements are inconsistent over time or incongruent with clinical presentation of an organic movement disorder; this may be supported by the presence of other definitely psychogenic signs (false weakness, false sensory findings, self-inflicted injuries), multiple somatizations, or an obvious psychogenic disturbance
Probable psychogenic movement disorder: 1) patients in whom movements are inconsistent or incongruent with an organic movement disorder but in whom there are no other features to provide support for the psychogenic diagnosis; 2) patients in whom abnormal movements are consistent and congruent with an organic movement disorder, but in whom other definitely psychogenic physical signs are present (see above); 3) patients in whom the movements are consistent and congruent with an organic movement disorder, but in whom multiple somatizations are present
Possible psychogenic movement disorder: suspected if an obvious psychiatric disturbance is present in a patient with abnormal movements that are consistent and congruent with an organic movement disorder; may have inappropriate affect, discrepancy between movement disorder and reported disability, or presence of secondary gain