# Hysteria
**Hysteria** is a historical medical term for a chronic, fluctuating disorder beginning in early life and characterized by recurrent and multiple somatic complaints not apparently due to physical illness; the diagnosis is not used in contemporary practice[1](https://www.ncbi.nlm.nih.gov/mesh/68007046). The [American Psychiatric Association](https://www.edgepedia.org/american-psychiatric-association) eliminated "hysterical neurosis" from the third edition of its *Diagnostic and Statistical Manual of Mental Disorders* (DSM-III) in 1980, and modern classifications distribute the phenomena the term once covered across conversion disorder, [dissociative disorders](https://www.edgepedia.org/dissociative-disorder), and histrionic personality disorder[2](https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/conversion-disorder-the-modern-hysteria/73F77976DFC9802B4C0E3EC7CA88F1A9) • [3](https://www.minervamedica.it/en/journals/minerva-psychiatry/article.php?cod=R17Y2010N04A0293). The word survives in everyday speech and in the compound "mass hysteria," and its clinical descendants remain common in neurological practice[4](https://pmc.ncbi.nlm.nih.gov/articles/PMC2235919).
| Key fact | Detail |
|---|---|
| Current status | MeSH describes hysteria as a historical term for a chronic, fluctuating disorder of multiple somatic complaints; "this diagnosis is not used in contemporary practice"[1](https://www.ncbi.nlm.nih.gov/mesh/68007046) |
| Etymology | From the Greek *husteros* (uterus), reflecting the early erroneous belief that such disorders were unique to women and originated in uterine disorders[5](https://dictionary.apa.org/hysteria) |
| Earliest records | The Kahun Gynaecological Papyrus, dated around 1990 BC; the word itself was coined in the Corpus Hippocraticum around 400 BC[6](https://www.ssdjournal.org/index.php/pub/article/download/118/112/225) • [7](https://www.sciencedirect.com/science/article/abs/pii/B9780128017722000011) |
| DSM history | "Hysterical neurosis" in DSM-II (1968); eliminated in DSM-III (1980) and replaced by dissociative and conversion disorders[2](https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/conversion-disorder-the-modern-hysteria/73F77976DFC9802B4C0E3EC7CA88F1A9) |
| Modern successor | Functional neurological symptom disorder (conversion disorder) in DSM-5 (2013); conversion disorder sits under dissociative (conversion) disorders F44 in ICD-10[8](https://pmc.ncbi.nlm.nih.gov/articles/PMC7440887/) • [2](https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/conversion-disorder-the-modern-hysteria/73F77976DFC9802B4C0E3EC7CA88F1A9) |
| Scale of the clinical problem | Unexplained motor and sensory symptoms such as paralysis, seizures, and blindness account for 1 to 9 percent of neurology inpatients and outpatients[9](https://pmc.ncbi.nlm.nih.gov/articles/PMC1273448/) |
| Misdiagnosis | A systematic review of studies since 1965 found subsequent disease diagnoses explaining the original symptoms in only about 4 percent of cases on average in studies from 1970 onward, down from high rates in early studies[9](https://pmc.ncbi.nlm.nih.gov/articles/PMC1273448/) |
## Origins and early theories
The English word is of Greek origin and linked to the womb. Recent scholarship on the Hippocratic Corpus shows that the Greek words behind "hysteria" did not name a specific clinical entity but offered an explanation for a multitude of symptoms, many gynecologic or related to pregnancy, in women; the view that hysteria was a disorder of women followed from this[7](https://www.sciencedirect.com/science/article/abs/pii/B9780128017722000011). In the Greco-Roman mind the complaints were tied to an animate or inanimate womb[10](https://www.sciencedirect.com/science/article/pii/S0022510X18300820). The physician and philosopher Claudius Galen, in the 2nd century AD, put forward a theory similar to [Hippocrates](https://www.edgepedia.org/hippocrates)', describing a "hysterical passion" with divergent symptoms that always referred to the uterus[6](https://www.ssdjournal.org/index.php/pub/article/download/118/112/225).
__A shift to the brain.__ Early in the 17th century, attention moved from the uterus to the brain as the organ of hysteria, initially with the uterus thought to influence the brain by "sympathetic" mechanisms involving blood vessels or nerves. At the same time it became accepted that men could also suffer from hysteria, a condition some authorities linked to hypochondria and melancholy[7](https://www.sciencedirect.com/science/article/abs/pii/B9780128017722000011). Through the 18th and 19th centuries hysteria was classified among the neuroses, in the original sense of a disorder of the function of the nervous system, and the mind joined the body as a source or trigger of symptoms[7](https://www.sciencedirect.com/science/article/abs/pii/B9780128017722000011).
## Charcot, Freud, and the psychological theories
In the late 19th century understanding advanced through the studies of [Jean-Martin Charcot](https://www.edgepedia.org/jean-martin-charcot) and his pupils, including Richer, Janet, and Babinski[11](https://www.cambridge.org/core/services/aop-cambridge-core/content/view/718E5EF12E6B404122987B9D472C571D/S0317167100040166a.pdf/hysteria_in_clinical_neurology.pdf). Charcot demonstrated hysterical paralysis and related phenomena, symptoms that were common in the 19th century[4](https://pmc.ncbi.nlm.nih.gov/articles/PMC2235919). Because the neurological symptoms of hysteria mimicked organic nervous system disorders but could be distinguished by careful attention to characteristic signs, the period also gave rise to the concept of feigning neurological disease[7](https://www.sciencedirect.com/science/article/abs/pii/B9780128017722000011).
In the late 19th and early 20th centuries new psychological theories invoked subconscious concepts such as dissociation, conversion, intrapsychic conflict, repression, and secondary gain, associated with Freud and Janet[7](https://www.sciencedirect.com/science/article/abs/pii/B9780128017722000011). Freud's work with hysteria formed the theoretical basis for the development of psychoanalysis; he interpreted hysterical symptoms as defenses against guilty sexual impulses and included dissociative conditions in his concept of hysteria, which modern classifications regard as separate disorders[12](https://pmc.ncbi.nlm.nih.gov/articles/PMC4695775/) • [5](https://dictionary.apa.org/hysteria). Paul Briquet's 1859 treatise described hysteria as a neurosis in a manner resembling modern ideas of mental illness, and somatization (psychological distress expressed as physical symptoms) disorder is still also called Briquet syndrome[13](https://pmc.ncbi.nlm.nih.gov/articles/PMC3091899/). [Joseph Babinski](https://www.edgepedia.org/joseph-babinski) later proposed the term pithiatism, and Freud's own label was conversion neurosis; the lineage runs today to functional neurological disorders in the 2013 DSM-5 classification[14](https://pubmed.ncbi.nlm.nih.gov/25273500/).
## Dismemberment in the diagnostic manuals
__From one category to several.__ DSM-II (1968) grouped conversion phenomena with dissociation under "hysterical neurosis," a title echoing the early uterine concept[2](https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/conversion-disorder-the-modern-hysteria/73F77976DFC9802B4C0E3EC7CA88F1A9). The DSM's move to classifying disorders by clinical phenomenology rather than causation eliminated "hysterical neurosis" from DSM-III (1980) and replaced it with dissociative disorders and conversion disorders[2](https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/conversion-disorder-the-modern-hysteria/73F77976DFC9802B4C0E3EC7CA88F1A9). The DSM-IV no longer considers hysteria, classically understood, and divided it into conversion disorder, dissociative disorders, and histrionic personality disorder[3](https://www.minervamedica.it/en/journals/minerva-psychiatry/article.php?cod=R17Y2010N04A0293).
The two main classification systems divided the inheritance differently, and commentators have called the dismemberment arbitrary. In DSM-IV conversion disorder is a somatoform disorder, while ICD-10 places it under dissociative (conversion) disorders (F44), alongside dissociative amnesia and fugue states[2](https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/conversion-disorder-the-modern-hysteria/73F77976DFC9802B4C0E3EC7CA88F1A9). The ICD-10 guidelines state that the term "hysteria" is best avoided because of its many and varied meanings, and that concepts such as "unconscious motivation" and "secondary gain" are not included among its diagnostic criteria[15](https://cdn.who.int/media/docs/default-source/classification/other-classifications/9241544228_eng.pdf?amp%3B=&sfvrsn=933a13d3_1).
DSM-5 (2013) addressed long-standing criticisms. The criteria dropped the requirement for a preceding psychological stressor and for the exclusion of feigning, so the diagnosis can rest primarily on neurological evidence and be made by a neurologist alone[8](https://pmc.ncbi.nlm.nih.gov/articles/PMC7440887/). The DSM-5 adopted "functional" as the primary descriptor in the term functional neurological symptom disorder, providing causative neutrality and potentially greater patient acceptance[16](https://pmc.ncbi.nlm.nih.gov/articles/PMC7293766/). The prior requirement that the symptom not be intentionally produced was removed because the distinction is difficult or impossible to make, with definite evidence of intentionality instead suggesting factitious disorder or malingering[12](https://pmc.ncbi.nlm.nih.gov/articles/PMC4695775/). The ICD-11 changes are less radical but place some subtypes of conversion disorder in the neurology section[8](https://pmc.ncbi.nlm.nih.gov/articles/PMC7440887/). Of the modern categories, [histrionic personality disorder](https://www.edgepedia.org/histrionic-personality-disorder) is the only one in diagnostic classifications that conserves a derivative of the old concept[17](https://www.frontiersin.org/articles/10.3389/fpsyg.2015.01463/pdf).
## Misdiagnosis and the "disappearance" of hysteria
A recurring clinical worry was that a patient labeled "hysteria" would later turn out to have a disease explaining the symptoms. Elliott Slater's highly influential 1965 *British Medical Journal* study reported a 10-year follow-up of patients admitted to the National Hospital for Nervous Diseases with a diagnosis of hysteria[18](https://psychiatryonline.org/doi/pdf/10.1176/jnp.2010.22.4.451.e13). A 2005 systematic review of all relevant studies since 1965 found that early studies reported high rates of such misdiagnosis, but that in studies from 1970 onward the average was only 4 percent; the authors attributed the decline to improvements in study quality rather than to improved diagnostic accuracy from the introduction of computed tomography of the brain[9](https://pmc.ncbi.nlm.nih.gov/articles/PMC1273448/).
The concern cuts both ways: it may encourage thorough assessment but also lead to overinvestigation and delayed treatment of potentially reversible conversion symptoms[9](https://pmc.ncbi.nlm.nih.gov/articles/PMC1273448/). Historians have argued that hysteria itself did not disappear in the 20th century; conversion symptoms remain common in neurological practice, and what faded was medical interest in hysteria, which contemporary neurology textbooks treated mainly as something to rule out rather than a condition requiring independent description[4](https://pmc.ncbi.nlm.nih.gov/articles/PMC2235919).
## Legacy
The label's decline reflected its overextension. Over the 20th century a litany of synonymous diagnostic labels appeared, including hysterical neurosis, conversion disorder, somatoform disorder, dissociative disorder, posttraumatic stress disorder, psychogenic disorder, and functional neurologic disorder, all converging in some way on the relationship between brain and mind[7](https://www.sciencedirect.com/science/article/abs/pii/B9780128017722000011).
Two descendants carry the term's inheritance. In clinical neurology and psychiatry, functional neurological disorder is now diagnosed positively through specific examination signs and characteristic patterns of symptom expression rather than as a diagnosis of exclusion[19](https://pmc.ncbi.nlm.nih.gov/articles/PMC12468249/). In social psychology, "mass hysteria" is studied as mass psychogenic illness, described as a social phenomenon affecting a certain proportion of a normal population under conditions of psychological and/or physical stress, and is considered a phenomenon distinct from clinical hysteria, the hysterical personality, or conversion reactions[20](https://stacks.cdc.gov/view/cdc/184299/cdc_184299_DS1.pdf).
## References
1. [Hysteria, MeSH, National Library of Medicine](https://www.ncbi.nlm.nih.gov/mesh/68007046)
2. [Owens C, Dein S. Conversion disorder: the modern hysteria, Advances in Psychiatric Treatment](https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/conversion-disorder-the-modern-hysteria/73F77976DFC9802B4C0E3EC7CA88F1A9)
3. [Hysteria: obsolete or actual disease?, Minerva Psichiatrica](https://www.minervamedica.it/en/journals/minerva-psychiatry/article.php?cod=R17Y2010N04A0293)
4. [The 'disappearance' of hysteria: historical mystery or illusion?, PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC2235919)
5. [Hysteria, APA Dictionary of Psychology](https://dictionary.apa.org/hysteria)
6. [Current Approaches in Psychiatry, DergiPark](https://www.ssdjournal.org/index.php/pub/article/download/118/112/225)
7. [Trimble M, Reynolds EH. A brief history of hysteria: from the ancient to the modern, Handbook of Clinical Neurology](https://www.sciencedirect.com/science/article/abs/pii/B9780128017722000011)
8. [Psychiatrists' Understanding and Management of Conversion Disorder: A Bi-National Survey, PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC7440887/)
9. [Stone J et al. Systematic review of misdiagnosis of conversion symptoms and "hysteria", BMJ](https://pmc.ncbi.nlm.nih.gov/articles/PMC1273448/)
10. [Hysteria in ancient civilisations: A neurological review, Journal of the Neurological Sciences](https://www.sciencedirect.com/science/article/pii/S0022510X18300820)
11. [Hysteria in clinical neurology, Canadian Journal of Neurological Sciences](https://www.cambridge.org/core/services/aop-cambridge-core/content/view/718E5EF12E6B404122987B9D472C571D/S0317167100040166a.pdf/hysteria_in_clinical_neurology.pdf)
12. [The Classification of Hysteria and Related Disorders: Historical and Phenomenological Considerations, PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC4695775/)
13. [Conversion disorder: advances in our understanding, PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC3091899/)
14. [History of physical and 'moral' treatment of hysteria, PubMed](https://pubmed.ncbi.nlm.nih.gov/25273500/)
15. [The ICD-10 Classification of Mental and Behavioural Disorders, World Health Organization](https://cdn.who.int/media/docs/default-source/classification/other-classifications/9241544228_eng.pdf?amp%3B=&sfvrsn=933a13d3_1)
16. [Current Concepts in Diagnosis and Treatment of Functional Neurological Disorders, PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC7293766/)
17. [Historical roots of histrionic personality disorder, Frontiers in Psychology](https://www.frontiersin.org/articles/10.3389/fpsyg.2015.01463/pdf)
18. [Over-Diagnosing Dissociative (Conversion) Disorders, Journal of Neuropsychiatry and Clinical Neurosciences](https://psychiatryonline.org/doi/pdf/10.1176/jnp.2010.22.4.451.e13)
19. [Risk, Precipitating, and Perpetuating Factors in Functional Neurological Disorder: A Systematic Review, PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC12468249/)
20. [Mass psychogenic illness in organizations: An overview, CDC Stacks](https://stacks.cdc.gov/view/cdc/184299/cdc_184299_DS1.pdf)
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*Topic: Encyclopedia › Society and history › Social life and human behavior › Psychology and behavior › Motivation, emotion, stress, and coping › Emotions and moods*
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