A 25-year-old woman develops sudden inability to move her left arm after witnessing a traumatic accident. Neurological examination shows no weakness, normal reflexes, and normal MRI. She appears indifferent to the loss of function ('la belle indifférence'). Which DSM-5 diagnosis is MOST appropriate?

• A Conversion Disorder (Functional Neurological Symptom Disorder) ✓
• B Somatic Symptom Disorder
• C Factitious Disorder
• D Malingering

Explanation

Conversion Disorder, renamed in DSM-5 as Functional Neurological Symptom Disorder (FNSD), involves altered voluntary motor or sensory function with positive neurological signs confirming incompatibility with neurological disease—NOT merely absence of organic pathology. La belle indifférence (relative lack of concern about significant neurological symptoms) is a classic associated feature. Unlike DSM-IV, DSM-5 no longer requires a psychological stressor as a criterion. Factitious Disorder involves intentional production of symptoms for sick-role benefits; Malingering involves external incentives (compensation, avoiding legal consequences).

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

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Written and medically reviewed by the StethoPrep medical team.