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Early intervention for conversion disorder: neurologists and psychiatrists working together

Published online by Cambridge University Press:  22 February 2013

Selma Aybek ,
Monica Hubschmid ,
Corinna Mossinger ,
Alexandre Berney  and
François Vingerhoets
Selma Aybek*
Affiliation:
Neurology Service, Department of Clinical Neuroscience, CHUV, Lausanne, Switzerland
Monica Hubschmid
Affiliation:
Liaison Psychiatry Service, Department of Psychiatry, CHUV, Lausanne, Switzerland
Corinna Mossinger
Affiliation:
Neurology Service, Department of Clinical Neuroscience, CHUV, Lausanne, Switzerland
Alexandre Berney
Affiliation:
Liaison Psychiatry Service, Department of Psychiatry, CHUV, Lausanne, Switzerland
François Vingerhoets
Affiliation:
Neurology Service, Department of Clinical Neuroscience, CHUV, Lausanne, Switzerland
*
Selma Aybek, Service de Neurologie, BH13 Bugnon 44, Lausanne 1011, Switzerland. Tel: +41795568716; Fax: +41213141244; E‐mail: selma.aybek@chuv.ch
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Abstract

Objective

To evaluate the efficacy of an early multidisciplinary (neurology and psychiatry) intervention for conversion disorder (CD).

Methods

Consecutive patients newly diagnosed with CD from 2005 to 2007 were compared to a control group of newly diagnosed CD patients receiving usual care. At 3 years, a questionnaire evaluated self‐rated subjective outcome, symptom severity, SF‐36 scores, employment status and medical care use.

Results

Data from 12 cases (mean age 25.5 ± 8.2; 9 females) and 11 controls (mean age 34.7 ± 13.5; 10 females) showed that 83% of cases had a good subjective outcome (symptom improved or cured) when only 36% of controls had a good outcome (p < 0.05). Cases significantly improved their SF‐36 scores on subscales involving physical complaints compared to controls. A minority (20%) of cases reduced or ceased professional activity when 70% of controls did (p < 0.001). Only 16% of cases sought further medical advice for the initial symptom when 73% of controls did. Both groups accepted psychiatric referrals (83% of cases and 73% of controls) and found it beneficial.

Conclusions

Early intervention involving both neurologists and psychiatrists is effective for CD in alleviating physical complaints, reducing sick leave and health care use.

Keywords

conversion disorderfunctional neurological symptomsoutcometreatment
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 25 , Issue 1 , February 2013 , pp. 52 - 56
Copyright
Scandinavian College of Neuropsychopharmacology 2013

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