Functional pain syndromes in the context of functional neurologicaldisorders. Part 2: Is hysteria as a construct dispensable?

Background: Functional neurological disorders (FND) are a new field of medicine. They are defined as conversion disorders. By using this term, the descriptors want to make the already outdated concept of hysteria superfluous. Question: Can the term hysteria be replaced by the definition of FND as a conversion disorder (CD)? Materials and methods: The functional pain syndromes complex regional pain syndrome (CRPS I) and fibromyalgia syndrome (FMS) and their relationships to CD and hysteria described in the FND publications to date are placed alongside the psychiatric publications on hysteria. Results: Use of the term CD is not uniform in the literature on FND. Some authors simply replace hysteria with CD, while others see FND as a multifactorial construct that does not exist solely as a result of conversion. From a psychiatric perspective, the psychodynamics of hysteria should be emphasized as a special feature in comparison to CD. Conclusion: It is therefore neither sufficient to use FND/CD as a substitute for the term hysteria nor to dispense with the clinical and psychodynamic picture of hysteria in a multifactorial approach. The term hysteria is therefore still not superfluous.