Hysteria, also known as hysteria, is a phenomenon of mental disorder induced by an individual’s apparent emotional factors, such as life events, internal conflicts, suggestion or self-referral, and includes both conversion disorder and dissociative disorder forms. The prevalence in the general population ranges from 3 to 10%. Childhood hysteria has obvious characteristics of collective episodes, mostly in school age, more frequent in girls, higher prevalence in rural than urban areas, and higher frequency of collective hysteria episodes in economically and culturally backward areas. Etiology 1, genetic factors: the high incidence in families suggests a genetic link. 2. Hysterical personality: characterized by emotional richness, exaggerated performance colors, and rich in fantasy, easily going from one extreme to another. Almost all children with hysteria develop under the action of psychological factors, such as self-esteem frustration, personality humiliation, family discord, parental conflict, parental mental abnormalities, parents’ hard attitude toward the child, disputes between classmates, etc. caused by anger, aggression, fear or other kinds of internal pain, can lead to the occurrence of the disease, the death of relatives or other unfortunate accident caused by strong emotional reaction also easy to lead to This disease can also occur due to strong emotional reactions caused by the death of a loved one or other unfortunate accidents. Inappropriate parenting style may also contribute to the development of the disease. The child’s personality is infantile, unstable, erratic, frivolous, and suggestible; similar situations, things, and conversations that led to the previous episode are suggestive and can induce another hysterical episode. Certain physical diseases, fatigue, lack of sleep, poor health and other reasons are also likely to promote the disease. Collective episodes often occur in classrooms, classrooms, playgrounds, group homes, or hospital wards. Related triggers can lead to collective fear and anxiety attacks, such as exams, harsh teachers, immunizations, patient-like behavior, death or injury of classmates, and meningitis epidemics. Some religious and superstitious activities, disasters, sudden life events, wars, social changes, etc. can also trigger collective hysteria attacks. This phenomenon is especially common in girls. 3, children are mostly primitive stress reactions: excitatory reactions (crying, laughter, irritability, etc.), inhibitory reactions (rigidity, drowsiness, paralysis, aphasia, etc.), and degenerative reactions (infantile behavior, etc.). In adults it is considered to be a purposeful reaction, and in case of distress hysteria attacks in order to get out of the situation. Dysthymia is a dysfunction of cortical and subcortical centers caused by intense or sustained stimulation of the cerebral cortex. Clinical manifestations 1. Dissociative hysteria: common symptoms include: emotional outbursts, primitive emotional reactions in early childhood, such as crying out, moving limbs, breath-holding, pale or blue face, incontinence, etc. In older children, the symptoms are irritability and irritability. In older children, the symptoms are irritability, crying, impulsiveness, sometimes pulling hair, tearing clothes, sometimes destroying surrounding drugs, sometimes rolling on the floor or twitching limbs, etc. The face is flushed, or there is a burst of hyperventilation, sweating and whistling. Emotional changes are intense, accompanied by dramatic expressions or exaggerated movements. The duration of the seizure is related to the degree of attention of the surrounding people, and there is partial amnesia after the seizure. 2, conversion hysteria: manifested as: sensory speech disorders: there is blindness, deafness, loss of voice, stuttering, hoarseness, etc. Hysterical amblyopia is a visual dysfunction caused by hysteria, characterized by the occurrence of emotional impulses, mostly manifested as black haze, sudden loss or loss of vision, diplopia, color vision, color blindness and phantom vision, etc. 3, spastic seizures: or straight limbs, or corns, or chest pounding. There is no fall, tongue bite, incontinence and hypoxia during the seizure. The face is as normal, the pupil response to light exists, and its seizures are significantly different from epilepsy. 4. Paralysis: Mostly, both lower limbs are paralyzed at the same time, but there is also monoplegia of upper or lower limbs. However, the child’s muscle tone and passive resistance are present, suggesting no signs of neurological damage. The site of paralysis may change during different episodes. The onset and improvement are relatively sudden. 5. Gait abnormalities: Although fainting complains of not knowing anything, the fall is slow and occurs mostly on a flat surface or in bed without danger, so it rarely causes self-injury. Some have an outburst of emotion (such as crying or laughing) first, while others have a spastic seizure at the same time. Seizures can be long or short, usually ranging from ten minutes to tens of minutes. Hysteria manifestations have the following common features: 1. The symptoms have no organic pathological basis and cannot be explained by neuroanatomy. 2. The rapidity and recurrence of symptom changes do not conform to the rules of organic diseases. The symptoms are exaggerated and performative. 4. Strong suggestibility, easily affected by the suggestion of the self or the surrounding environment, and can be aggravated or improved by the suggestion. Diagnosis 1. Clinical features of dissociative or conversion dysthymia are present. 2. There is no organic basis to explain the symptoms. 3. There is a psychological or emotional trigger basis, and the presentation is clearly linked in time to a stressful event, problem, or disorder (even if the child denies this). It must be differentiated from seizures, reactive psychosis and schizophrenia. Treatment The main use of psychotherapy in the case of seizures is: 1. Eliminate the negative suggestive effects of language and behavior of the surrounding people. 2. Eliminate the atmosphere of tension and anxiety, and do not express excessive concern and care. Do not make unnecessary medical examinations to avoid reinforcing their symptomatic attacks; 3. Use acupuncture, acupoint injection, electrical stimulation, intravenous calcium gluconate, etc., to both act as a benign suggestion and improve the symptoms of dizziness and headache, palpitations, muscle aches, and anxiety after an attack. Treatment should be individualized, that is, according to the personality of the child, psychological characteristics, the cause of the disease, the environment in which the child is located to develop a treatment plan. Diazepam or small doses of new antipsychotics can be given to children with obvious psychotic symptoms of hysteria or spasticity. Long-term medication is not recommended for children under 10 years of age, as it may increase the suggestive effect and consolidate the disease and make the episodes habitual. Children should be helped to understand the disease properly and taught about the disease, so that they understand that the disease is a temporary brain dysfunction due to the dysfunction of higher neural activity and is completely curable. It is also necessary to make the child understand that hysteria attacks are related to his or her emotional experience, and to make him or her realize the relationship between certain personality traits and the onset of the disease, so that the child can reduce psychological pressure and build confidence to overcome the disease. Measures to prevent seizures vary from person to person, such as children often have certain symptoms before the seizure, at this time, they can be made to consciously divert their attention, do something to lift, or temporarily leave the environment to change the state of mind, which can often prevent seizures. It is also significant to pay attention to the reasonable arrangement of life, pay attention to the combination of work and rest, to ensure sufficient sleep, to improve the working ability of the cerebral cortex, to prevent seizures. In addition, if children can recognize and consciously pay attention to the release of their unhealthy character traits, with a correct attitude towards their own study, work, life, improve interpersonal relationships, and correctly deal with various conflicts and frustrations, it is more important for the complete treatment of the disease. Working well with people around the child, such as classmates and relatives, is also a very important aspect of treating the disease. They should be introduced to the characteristics of the disease, to relieve concerns about the disease, to change incorrect attitudes, especially in the onset of the patient, to avoid the adverse effects of excessive tension and excessive concern caused by the surrounding people. Group psychotherapy should be given to group attacks of hysteria. The children should be divided into groups according to their condition, age and education level, and group games and lectures should be chosen to explain the cause of the disease, eliminate tension and relieve somatic discomfort.