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Early intervention for conversion disorder: neurologists and psychiatrists working together

Aybek, Selma ; Hubschmid, Monica ; Mossinger, Corinna ; Berney, Alexandre ; Vingerhoets, François

In: Acta Neuropsychiatrica, 2013, vol. 25, no. 1, p. 52-56

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    Title
    • Early intervention for conversion disorder: neurologists and psychiatrists working together
    Author
    • Aybek, Selma. Neurology Service, Department of Clinical Neuroscience, CHUV, Lausanne, Switzerland
    • Hubschmid, Monica. Liaison Psychiatry Service, Department of Psychiatry, CHUV, Lausanne, Switzerland
    • Mossinger, Corinna. Neurology Service, Department of Clinical Neuroscience, CHUV, Lausanne, Switzerland
    • Berney, Alexandre. Liaison Psychiatry Service, Department of Psychiatry, CHUV, Lausanne, Switzerland
    • Vingerhoets, François. Neurology Service, Department of Clinical Neuroscience, CHUV, Lausanne, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:297898
    Summary
    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