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October 15, 1982

Hysteria and Hysterical Conversion Reactions-Reply

JAMA. 1982;248(15):1833. doi:10.1001/jama.1982.03330150026010

In Reply.—  I welcome the opportunity to respond to Dr Weintraub's letter, since it illustrates so well the pitfalls of ignoring the clear clinical distinction between two sets of concepts. The disagreement here stems largely from confusing two separate topics. My topic was classic hysteria as recognized by Hippocrates, Briquet, Robins, Guze, and others. Weintraub's topic is what he calls "HCRs." Dr Weintraub imagines that the controversy surrounding hysteria is because psychiatrists, who see a relatively small proportion of hysterics, are the most prolific writers on the subject. In actuality, the controversy stems from the fact that some confuse a single symptom (conversion reaction) with a diagnosis, while others retain a classic, clinical-descriptive approach to a syndrome that has a defined natural history. The syndrome or disease of hysteria (Briquet's syndrome) has been clinically described and delimited from other diseases.1,2 It is substantially represented in hospital and psychiatric clinic