A Descriptive Study on the Clinical Correlates of Conversion Disorder

2021 ◽  
Vol 8 (12) ◽  
pp. 513-529
Author(s):  
Ronald Roy K
Keyword(s):  
Tertiary Care ◽  
Depression Scale ◽  
Conversion Disorder ◽  
Communication Process ◽  
Motor Disorder ◽  
Depression And Anxiety ◽  
Psychiatric Facility ◽  
Conversion Disorders ◽  
Number Of Patients ◽  
Dissociative Convulsions

Aim: Conversion disorder is defined by the presence of deficits affecting the voluntary motor or sensory functions lacking any known neurological cause. The aim of the study is to describe the sociodemographic profile and clinical characteristics including the frequency distribution of various types of presentations of patients with conversion disorders in a tertiary care psychiatric facility and to assess the presence of depression and anxiety and its level of severity in those patients. Methods: After obtaining informed consent, 50 consecutive patients who had met with the ICD-10 diagnosis criteria for conversion disorder and those who meet the inclusion/exclusion criteria, were enrolled for the study. They were interviewed using a semi-structured Performa and were administered Hospital Anxiety and Depression scale (HADS) and the results were analysed using SPSS software and interpreted. Results: Majority of the study patients were young adolescents (48%), females (76%), rural residents (60%), mostly unmarried (46%). Dissociative motor disorders (30%) were the most common presentation followed by mixed dissociative disorder (26%) and Dissociative convulsions (22%). HAD scale revealed that, both depression and anxiety scores were significantly high in major number of patients. Conclusion: The most common presenting symptom was that of dissociative motor type followed by dissociative convulsions with considerably high rates of depression (48%) and anxiety (54%). This made us to conclude that conversion as a phenomenon emerges to uphold its significance as a non-verbal communication process of the subconscious Mind. Keywords: Conversion, Dissociation, Hysteria, Dissociative Motor Disorder, Dissociative Convulsions, Laterality, Depression, Anxiety.

scholarly journals Prevalence of Depression and Anxiety amongst Cancer Patients in a Hospital Setting: A Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Anish Khalil ◽  
Muhammad Faheem ◽  
Ammad Fahim ◽  
Haran Innocent ◽  
Zainab Mansoor ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Mental Wellbeing ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Sectional Study ◽  
Cross Sectional

Background. The biomedical care for cancer has not been complemented by psychosocial progressions in cancer care.Objectives. To find the prevalence of anxiety and depression amongst cancer patients in a hospital setting.Design and Setting. This cross-sectional study was conducted at the tertiary care hospitals Shifa International Hospital Islamabad and Nuclear Medicine, Oncology, and Radiotherapy Institute [NORI].Patients and Methods. 300 patients were interviewed from both the outpatient and inpatient department using The Aga Khan University Anxiety and Depression Scale (AKUADS).Main Outcome Measures. Using a score of 20 and above on the AKUADS, 146 (48.7%) patients were suffering from anxiety and depression.Results. When cross tabulation was done between different factors and the cancer patients with anxiety and depression, the following factors were found out to be significant with associatedpvalue < 0.05: education of the patient, presence of cancer in the family, the severity of pain, and the patient’s awareness of his anxiety and depression. Out of 143 (47.7%) uneducated patients, 85 (59.4%) were depressed, hence making it the highest educational category suffering from depression and anxiety.Conclusion. The prevalence of anxiety and depression amongst cancer patients was high showing that importance should be given to screening and counseling cancer patients for anxiety and depression, to help them cope with cancer as a disease and its impact on their mental wellbeing.Limitations. The frequency of female patients in our research was higher than those of male patients.

scholarly journals Conversion Disorder in Children: Characteristics and Gender Differences

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
M Anupama ◽  
Uttam Shelar ◽  
Jitty George ◽  
Babool Raja
Keyword(s):  
Gender Differences ◽  
Interpersonal Relationships ◽  
Conversion Disorder ◽  
Complete Recovery ◽  
Stress Factors ◽  
Response To Treatment ◽  
Motor Disorder ◽  
Conversion Disorders ◽  
Common Diagnosis ◽  
And Gender

Aim: To study the clinical presentations and gender differences of conversion disorder in children less than 16 year old and correlate it with socio-demographic characteristics and stress factors. Methods: All case records of children presenting to psychiatry unit of a general hospital during last 5 years (both outpatient and inpatient) and having a diagnosis of ICD-10 Dissociative (conversion) disorders, were reviewed. Results: A total of 12 % ( n=512) had a diagnosis of conversion disorder, both genders having equal representation. Dissociative motor disorder was more common among males and dissociative convulsions among females. Academic and strained interpersonal relationships were the most common stress factors. Majority had la belle indifference and secondary gain and received outpatient treatment, and had complete recovery at last follow up. Conclusions: Conversion disorders are one of the most common diagnosis. Significant gender differences in mode of presentation and nature of stress are present. However the response to treatment is prompt and chance of recovery is high in both genders. Relevance: This study was done in a developing country where conversion disorder is seen commonly.

scholarly journals Depression and Anxiety in Patients With Cancer: A Cross-Sectional Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Abdallah Y. Naser ◽  
Anas Nawfal Hameed ◽  
Nour Mustafa ◽  
Hassan Alwafi ◽  
Eman Zmaily Dahmash ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Patients ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Outpatient Setting ◽  
Small Sample ◽  
Psychological Status ◽  
Inpatient Setting ◽  
Depression And Anxiety ◽  
Number Of Patients

ObjectivesDepression and anxiety persist in cancer patients, creating an additional burden during treatment and making it more challenging in terms of management and control. Studies on the prevalence of depression and anxiety among cancer patients in the Middle East are limited and include many limitations such as their small sample sizes and restriction to a specific type of cancer in specific clinical settings. This study aimed to describe the prevalence and risk factors of depression and anxiety among cancer patients in the inpatient and outpatient settings.Materials and MethodsA total of 1,011 patients (399 inpatients and 612 outpatients) formed the study sample. Patients’ psychological status was assessed using the Hospital Anxiety and Depression Scale (HADS), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The prevalence rate of depressive and anxious symptomatology was estimated by dividing the number of patients who exceeded the borderline score: 10 or more for each subscale of the HADS scale, 15 or more for the GAD-7 scale, and 15 or more in the PHQ-9 by the total number of the patients. Risk factors were identified using logistic regression.ResultsThe prevalence of depressive and anxious symptomatology among all patients was 23.4% and 19.1–19.9%, respectively. Depressive symptomatology was more prevalent across patients who were hospitalized (37.1%) compared with patients in the outpatient setting (14.5%) (p &lt; 0.001). Similarly, anxious symptomatology was more prevalent in the inpatient setting (p &lt; 0.001). In the inpatient setting, depressive symptomatology was more prevalent among patients with bladder cancer, while severe anxious symptomatology was more prevalent across patients with lung cancer. In the outpatient setting, depressive and anxious symptomatology was more prevalent among breast and prostate cancer patients, respectively. Despite that, around 42.7% and 24.8% of the patients, respectively, reported that they feel anxious and depressed, and only 15.5% of them were using medications to manage their conditions.ConclusionOur study findings demonstrated a higher prevalence of depressive and anxious symptomatology in the inpatient setting and advanced disease stages. In addition, the underutilization of antidepressant therapy was observed. There is a need to consider mental disorders as part of the treatment protocol for cancer patients. Enhanced clinical monitoring and treatment of depression and anxiety of cancer patients are required.

Neuroanatomy of conversion disorder: towards a network approach

2018 ◽  
Vol 29 (4) ◽  
pp. 355-368 ◽  
Author(s):  
Ismael Conejero ◽  
Eric Thouvenot ◽  
Mocrane Abbar ◽  
Stéphane Mouchabac ◽  
Philippe Courtet ◽  
...  
Keyword(s):  
Conversion Disorder ◽  
Functional Brain Imaging ◽  
Motor Disorder ◽  
Medical Subject Headings ◽  
Limb Weakness ◽  
Memory Suppression ◽  
Motor Intention ◽  
Positron Emission ◽  
Conversion Disorders ◽  
Meta Analyses

Abstract The pathophysiology of conversion disorder is not well understood, although studies using functional brain imaging in patients with motor and sensory symptoms are progressively increasing. We conducted a systematic review of the literature with the aim of summarising the available data on the neuroanatomical features of this disorder. We also propose a general model of the neurobiological disturbance in motor conversion disorder. We systematically searched articles in Medline using the Medical Subject Headings terms ‘(conversion disorder or hysterical motor disorder) and (neuropsychology or cognition) or (functional magnetic resonance imaging or positron emission tomography or neuroimaging) or (genetics or polymorphisms or epigenetics) or (biomarkers or biology)’, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two authors independently reviewed the retrieved records and abstracts, assessed the exhaustiveness of data abstraction, and confirmed the quality rating. Analysis of the available literature data shows that multiple specialised brain networks (self-agency, action monitoring, salience system, and memory suppression) influence action selection and modulate supplementary motor area activation. Some findings suggest that conceptualisation of movement and motor intention is preserved in patients with limb weakness. More studies are needed to fully understand the brain alterations in conversion disorders and pave the way for the development of effective therapeutic strategies.

scholarly journals SAT0618-HPR PATIENTS WITH INFLAMMATORY MYOPATHIES WHO DO NOT REACH HEALTH ENHANCING LEVELS OF PHYSICAL ACTIVITY REPORT HIGHER LEVELS OF ANXIETY AND DEPRESSION - A CROSS-SECTIONAL STUDY OF SELF-REPORTED DATA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1269.2-1269
Author(s):  
K. Andreasson ◽  
H. Sandlund ◽  
H. Alexanderson
Keyword(s):  
Physical Activity ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Inflammatory Myopathies ◽  
Hospital Anxiety ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Reported Data ◽  
Anxiety Depression

Background:The adult idiopathic inflammatory myopathies (IIM) comprise dermatomyositis (DM), polymyositis (PM), immune-mediated necrotizing myopathy (IMNM), antisynthetase syndrome (ASS), overlap myositis and inclusion body myositis (IBM). Impaired physical capacity, self-reported fatigue and pain are common features in IIM. Quality of life is reduced compared to population-based reference values. To our knowledge self-reported levels of physical activity has not been studied in patients with IIM. Further, anxiety and depression are common in other rheumatic diseases, such as SLE, but is less studied in IIM, and not previously in relation to levels of physical activity. There is evidence for symptom reducing effects of exercise for patients suffering from depression (1).Objectives:The objective of this study is to assess the levels of self-reported physical activity, depression and anxiety amongst adult patients with IIM. A further aim is to evaluate differences in anxiety/depression based on levels of physical activity as well as to analyze relationships between physical activity and anxiety/depression.Methods:All patients with IIM visiting the Rheumatology clinic at Karolinska University Hospital in Solna between February 2019 and January 2020 where asked to fill in questionnaires about their levels of physical activity for the last seven days using the International Physical Activities Questionnaire – short form (IPAQ), and anxiety and depression using Hospital Anxiety and Depression Scale (HADS). The myositis team nurse distributed the questionnaires. Spearman’s rho was used for correlation analysis. Kruskal-Wallis test and post-hoc adjustment with Bonferroni correction was used to analyze group differences. HADS is scored in two separate scales, one for depression (HADS-D) and one for anxiety (HADS-A). The cut-off value for probable depression or anxiety is ≥8 of a maximum of 21 per scale (2). IPAQ-results was scored as 1 (low, < 150 min/w), 2 (moderate, ≥ 150 min/w – health-enhancing levels of physical activity, HEPA, according to WHO) and 3 (high, ≥ 300 min/w).Results:A total of 61 patients answered the questionnaires. 52 (85 %) of the patients reported to reach HEPA and 24 of these patients reported to be active on a high level. 22 patients (36 %) scored probable anxiety or depression, with six scoring ≥8 for both depression and anxiety. Patients with low levels of physical activity (IPAQ-1) scored significantly higher anxiety and depression compared to those reaching HEPA (IPAQ-2 and IPAQ-3) p<0.0001 – 0.020. The correlation between physical activity and depression (Fig. 1) was rs=-0.48 (-0.66; -0.26) and between physical activity and anxiety (Fig. 2), rs=-0.27 (-0.49; -0.02).Conclusion:Self-reported data indicates that most patients with IIM in this sample reached HEPA level or higher. Patients who do not reach HEPA score significantly higher anxiety and depression compared to those reaching HEPA. However, levels of physical activity correlates moderately to depression and weakly to anxiety. The number of patients who reached HEPA is high compared to studies in rheumatoid arthritis or the general population. This could be explained by frequent visits to physical therapists early in the disease and yearly check-ups with a focus on exercise and physical activity. Further the inter-professional myositis team also has a focus on exercise and the importance of everyday physical activity. This is cross-sectional, self-reported data and longitudinal studies are needed also including objective measures. This is preliminary data with data collection ongoing throughout 2020.References:[1]Craft, LL et al. The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry. 2004;6(3):104-111[2]Zigmond, AS et al. The hospital anxiety and depression scale. Acta Psychiat. Scand. 1983;67(6):361-70Disclosure of Interests:None declared

scholarly journals Disability, anxiety and depression associated with medication-overuse headache can be considerably reduced by detoxification and prophylactic treatment. Results from a multicentre, multinational study (COMOESTAS project)

Cephalalgia ◽  
2013 ◽  
Vol 34 (6) ◽  
pp. 426-433 ◽  
Author(s):  
L Bendtsen ◽  
SB Munksgaard ◽  
C Tassorelli ◽  
G Nappi ◽  
Z Katsarava ◽  
...  
Keyword(s):  
Prophylactic Treatment ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Hospital Anxiety ◽  
Number Of Patients ◽  
Degree Of Disability ◽  
Midas Questionnaire

Objective The objective of this article is to investigate whether headache-related disability, depression and anxiety can be reduced by detoxification and prophylactic treatment in patients with medication-overuse headache (MOH). Methods Patients with MOH were included from six centres in Europe and Latin America in a seven-month cohort study. Before and six months after treatment, the degree of disability was measured by the Migraine Disability Assessment (MIDAS) questionnaire, while anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS). Results A total of 694 patients with MOH were included, of whom 492 completed the study. Headache days were reduced by 58.4% from 23.6 to 9.8 days per month at six months ( p < 0.001). The MIDAS score was reduced by 57.1% from baseline 59.9 to 25.7 ( p < 0.001). Number of patients with depression was reduced by 50.7% from 195 to 96 and number of those with anxiety was reduced by 27.1% from 284 to 207 (both p < 0.001). Conclusions Disability, depression and anxiety were considerably reduced in patients with MOH by detoxification and prophylactic treatment. This emphasises the urgent need for increased awareness about avoiding overuse of headache medications and demonstrates that not only headache frequency but also disability are remarkably improved by adequate intervention.

scholarly journals Frequency of anxiety and depression in dissociative trance (possession) disorder

2021 ◽  
Vol 15 (2) ◽  
pp. 72-75
Author(s):  
Ammara Butt ◽  
Azmat Ahad Beig ◽  
Junaid Ul Islam ◽  
Fatima Saleem
Keyword(s):  
Rating Scale ◽  
Tertiary Care ◽  
T Test ◽  
Anxiety And Depression ◽  
P Value ◽  
Depression And Anxiety ◽  
Female Patients ◽  
Conversion Disorders ◽  
Icd 10 ◽  
Dissociative Trance Disorder

Background: The possession of a person by God or spirit is an age-old one. The ICD-10 has recorded the presence of a possession and trance disorder before formal featuring it in the 10th edition as a category of dissociative (conversion) disorders. The current study sought to determine the frequency of anxiety and depression among the patients presented in tertiary care hospitals with dissociative trance (possession) disorder, along with gender differences. Patients and methods: This cross-sectional study was conducted at l Department of Psychiatry, Sir Ganga Ram Hospital Lahore over one year: December 2019 till December 2020. A sample of 350 patients, who met the ICD-10 criteria of dissociative trance (Possession) disorder, was recruited in the study through purposive sampling technique. Demographic information sheet and Urdu version of the Hospital Anxiety and Depression (HAD) rating scale were used as assessment measures. The data were stored and analyzed in SPSS version 20. Descriptive analysis i.e., means, standard deviations, percentages, and frequencies, and inferential statistics i.e., independent sample t-test, were performed to explore objectives. Results: The results indicate that 13.2 % of patients with dissociative trance disorder scored in the normal range of depression, 20.7% fall in borderline depression while abnormal, and 66.1% in abnormal cases of depression was found in 66.1% of patients. For anxiety, results demonstrate that 28.2% of patients fall in the category of normal anxiety, 3 31.5% in borderline anxiety, and 40.3% fall in the case of abnormal anxiety. Differences for the gender of patients in depression and anxiety scores were evaluated by independent sample t-test and significant differences were found in depression and anxiety scores of male and female patients with dissociative trance disorder (p-value<0.05). Female patients scored high on depression (19.84±6.68) and anxiety (16.02±5.54) scale than male patients’ scores for depression (27.47±5.06) and anxiety (19.35±4.95). Conclusion: There is a definite frequency of depression and anxiety among patients with, dissociative trance disorder while females are high in the scores. This can help to decrease the comorbidity associated with dissociative trance disorder, reduce the disease burden and ensure a better outcome of treatment

Changes in anxiety and depression symptoms associated to the outcome of MOH: A post-hoc analysis of the Comoestas Project

Cephalalgia ◽  
2017 ◽  
Vol 38 (4) ◽  
pp. 646-654 ◽  
Author(s):  
Sara Bottiroli ◽  
Marta Allena ◽  
Grazia Sances ◽  
Roberto De Icco ◽  
Micol Avenali ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Affective State ◽  
Antidepressant Drugs ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Number Of Patients ◽  
The Impact

Aims To evaluate the impact of treatment success on depression and anxiety symptoms in medication-overuse headache (MOH) and whether depression and anxiety can be predictors of treatment outcome. Methods All consecutive patients entering the detoxification program were analysed in a prospective, non-randomised fashion over a six-month period. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale. Results A total of 663 MOH patients were evaluated, and 492 completed the entire protocol. Of these, 287 ceased overuse and reverted to an episodic pattern (responders) and 23 relapsed into overuse. At the final evaluation, the number of patients with depressive symptoms was reduced by 63.2% among responders ( p < 0.001) and did not change in relapsers ( p = 0.13). Anxious symptomatology was reduced by 43.1% in responders ( ps < 0.001) and did not change in relapsers ( p = 0.69). At the multivariate analysis, intake of a prophylactic drug and absence of symptoms of depression at six months emerged as prognostic factors for being a responder (OR 2.406; p = 0.002 and OR 1.989; p = 0.019 respectively), while lack of antidepressant drugs and presence of symptoms of depression at six months were prognostic factors for relapse into overuse (OR 3.745; p = 0.004 and OR 3.439; p = 0.031 respectively). Conclusions Symptomatology referred to affective state and anxiety can be significantly reduced by the treatment of MOH. Baseline levels of depression and anxiety do not generally predict the outcome at six months. Their persistence may represent a trait of patients with a negative outcome, rather than the consequence of a treatment failure.

scholarly journals Prevalence of anxiety and depressive symptoms among emergency physicians in Libya after civil war: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039382
Author(s):  
Muhammed Elhadi ◽  
Ala Khaled ◽  
Ans Bassam Malek ◽  
Ahmed El-Alem El-Azhari ◽  
Ahmed Zakaria Gwea ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Measurement Tool ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Emergency Physicians ◽  
Sectional Study ◽  
Cross Sectional

ObjectivesWe aimed to identify the prevalence of depression and anxiety among physicians working in the emergency departments of nine tertiary care centres in Libya.DesignThis was a cross-sectional study.SettingNine main tertiary centres in LibyaParticipantsEmergency department doctors were surveyed between December 2018 and February 2019.InterventionThe standardised Hospital Anxiety and Depression Scale (HADS) was selected as a measurement tool for analysing anxiety and depression symptoms; a HADS score of 8 indicated anxiety as well as depression symptoms. The primary outcomes were anxiety and depression, which were tabulated with independent sociodemographic variables. χ2 tests were conducted to compare the prevalence of anxiety and depression between the groups. Statistical analysis was performed using SPSS V.25.ResultsA total of 108 out of 150 (72%) emergency physicians from all levels participated in the study and took the survey. The emergency physicians had a mean±SD age of 31.2±4.5 years, and were predominantly males (74 out of 108, 68.5%). Overall, 49 (45.4%) physicians reached the cut-off score to define both depression and anxiety (ie, a score ≥8). In terms of violence, 71 (65.7%) reported incidents of verbal violence, while 26 (24.1%) reported physical violence or abuse by militias. In addition, 28 reported being threatened by militias.ConclusionThe high prevalence rate of anxiety and depression is of concern, and the high rate of physical and verbal abuse highlights the range of abuse endured by doctors in Libya. Therefore, screening for anxiety and depression at regular intervals is needed to avoid the deterioration of mental health, which can increase the risk of suicide and dropping out, and decrease the level of healthcare for patients.

scholarly journals Demographic and clinical characteristics of patients presenting with conversion disorder in a tertiary care hospital in north India

2021 ◽  
Vol 9 (2) ◽  
pp. 535
Author(s):  
Haamid Ismail ◽  
Sabreena Qadri ◽  
Arshad Hussain ◽  
Nadia Ismail
Keyword(s):  
Clinical Characteristics ◽  
Tertiary Care ◽  
Conversion Disorder ◽  
Sensory Function ◽  
North India ◽  
Care Hospital ◽  
Rural Background ◽  
Medical College ◽  
Conversion Disorders ◽  
Study Population

 Background: Conversion (functional neurological symptom) disorder refers to patients who have neurological symptoms in the absence of neurological disease, encompassing one or more symptoms of altered voluntary motor or sensory function. Aim of the study was to study the demographic and clinical characteristics of patients with conversion disorder.Methods: The study population comprised all the patients (both inpatients and outpatients) of conversion disorder attending department of psychiatry, government medical college Srinagar over a period of 6 months who fulfilled the inclusion criteria of the study were evaluated on a semi-structured proforma for demographic variables and clinical characteristics.Results: A total of 76 patients of conversion disorder were included in our study. Conversion disorder is more common in age group of 20-29 years (52.6%), females (93.4%) and among students (71.1%) belonging to rural background. Motor symptoms were the predominant presentation with pseudo seizure (69.7%) being the commonest. A majority of the patients had an obvious psychosocial stressor, of which family-related (36.8%) and relationship- related (15.8%) problems accounted for the major types.Conclusions: Conversion disorders are commonly seen in young adult females, students and in those from rural background. They are mostly preceded by psychosocial stressors.

Sign in / Sign up

Export Citation Format

Share Document