La belle indifférence (apparent lack of concern about a serious neurological symptom) is classically associated with which disorder, though is no longer considered pathognomonic in DSM-5?

• A Generalised Anxiety Disorder
• B Borderline Personality Disorder
• C Conversion Disorder (Functional Neurological Symptom Disorder) ✓
• D Somatic Symptom Disorder

Explanation

La belle indifférence — seeming indifference toward what appears to be a significant neurological deficit — is the classical historical feature of conversion disorder (FNSD). However, DSM-5 explicitly notes that la belle indifférence is not pathognomonic, as it occurs in some organic neurological conditions and may be absent in many FNSD patients. DSM-5 diagnosis of FNSD relies on positive features of functional aetiology (clinical signs demonstrating internal inconsistency), not psychological stressors or la belle indifférence.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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Written and medically reviewed by the StethoPrep medical team.