| Abstrakt: |
To the Editor.—The three cases of respiratory distress associated with wheezing heard loudest over the larynx and normal pulmonary function certainly point out the value of a careful physical examination and sensitivity to the patient's emotional history to avoid unnecessary treatment for asthma (1982;248:2878). However, factitious illness was not the best diagnosis in at least two of the cases (2 and 3) and probably a third (case 1). Conversion disorder, with or without a concurrent anxiety disorder, would be much more likely and helpful to consider in these cases.Conversion disorder involves a loss or alteration of physical function, often in the voluntary nervous system. The change in function is thought to be associated with channeling of anxiety about psychological conflicts into somatic outlets, which is not explained by known physiological disease and in which a temporal connection is found between the onset of physical symptoms, psychological disturbance, and |
