January 20, 2012

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N.Y. teens' mystery illness labeled 'conversion disorder'

It's a term used so rarely that most of us haven't heard of it. Even mental health professionals say they have read about it in textbooks rather than seen it up close.

But the mysterious symptoms of facial tics and verbal outbursts afflicting 12 in the small community of LeRoy, N.Y., has brought new awareness to a very unfamiliar stress-related condition referred to as "conversion disorder."

Conversion disorder is characterized by problems with voluntary motor or sensory function that suggest a neurological or other general but aren't fully consistent with known biological causes or explanations, says David Fassler, a child and adolescent psychiatrist at the University of Vermont in Burlington. He says such outbreaks are more common in women and are associated with stress or anxiety. The girls began exhibiting symptoms last fall.

Laszlo Mechtler of the Dent Neurologic Institute in Buffalo, who has treated all but one of the 12 girls, says tests have ruled out medical disorders, diseases and . "These young ladies are individuals who come from a small community. One may have had a significant symptom, and it was like a wildfire."

When conversion disorder occurs in a larger group, it's called "mass psychogenic illness," Mechtler says.

A mass psychogenic illness affects groups of people in the same environment, such as a class at school or workers in an office who get similar physical symptoms at the same time.

That's why he says the publicity surrounding the case doesn't mean teenage girls around the U.S. will start exhibiting similar symptoms.

"You have to be in that environment. This is a unique situation, and it is unusual," he says, noting that in 25 years, he has never seen a group with these symptoms, but he has seen people diagnosed with conversion disorder.

Mechtler says that after getting permission from several families, doctors chose to speak out about the situation to stop misinformation and allay fears.

Clinical psychologist Nancy Molitor of Wilmette, Ill., who treats adolescents, says the disorder tends to occur in "close-knit communities where everybody knows everybody. I would want to know about what's going on in the community culturally and religiously and socially.

"Teenage girls are very susceptible to drama and each other's moods," she adds.

Mechtler says the girls being treated are improving.

"Part of the treatment is reassuring the patients and families that they do not suffer from an organic neurological disease," he says.

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