A Descriptive Study on the Clinical Correlates of Conversion Disorder

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.

COVID-19 pandemic and quarantine-related health disorders in combatants of Ukraine

Here we expand the existing knowledge about disorders associated with the COVID-19-related pandemic and quarantine. We show that the COVID-19-related pandemic and quarantine can reduce the combat effectiveness of the military, provoking a deterioration in the health of combatants and requires hospitalization. Aim. Investigate the impact of the COVID-19 pandemic and quarantine on the health of Ukrainian combatants. Material and methods. A study was conducted between March 12, 2020 and May 22, 2020 at the Department of Psychiatry, Psychotherapy, General and Medical Psychology, Narcology, and Sexology in Zaporizhzhia State Medical University and Zaporizhzhia military hospital (Ukraine). All combatants who were hospitalized during this period were examined. We analyzed medical records, anamnestic data, and performed psychopathological and psychological examinations of all patients. Results. In 56 % of combatants hospitalized during high quarantine measures, the cause of health disorders is negative COVID-19 pandemic and quarantine-related thoughts that provoke stress. These stressful thoughts associated with the COVID-19 pandemic and quarantine provoke the development of hypertensive emergency (57 % vs 18 %), anxiety syndrome (29 %), dissociative [conversion] disorder (7 %), and exacerbate the negative effects of pre-pandemic diseases, namely, hypertension (43 % vs 27 %), somatoform autonomic dysfunction of the cardiovascular system (29 %), panic disorder [episodic paroxysmal anxiety] (7 %), adjustment disorders (7 %), post-traumatic stress disorder (7 %). Conclusions. Preventive measures need to be developed and applied to combatants to prevent their deteriorating health due to the effects of the COVID-19 pandemic and quarantine stress

The relationship between types of life events and the onset of functional neurological (conversion) disorder in adults: a systematic review and meta-analysis

Adverse life events precede the onset of functional neurological disorder (FND, also known as conversion disorder) more commonly than other neuropsychiatric conditions, but their aetiological role is unclear. We conducted a systematic review and quantitative analysis of the type, timing and number of life events preceding the onset of FND in adults, and a meta-analysis of the proportions of types of events in controlled studies. Fifty-one studies of different designs, covering 4247 patients, were eligible for inclusion. There was no clear majority of any type of preceding event. Family problems were the most common category of events, followed by relationship problems. Females were more likely to experience preceding family/relationship problems than males, who reported more work problems. Family problems were the commonest type of preceding event in studies in developing countries, whereas family and health problems were equally common in developed countries. Abuse was associated with early symptom onset, while patients with later onset were more likely to report family problems. The median number of events was one, and the events occurred closer to onset than in controls. Meta-analysis found that family, relationship and work events were all relatively more common in patients than pathological controls, as were events where symptoms might provide a solution to the stressor. In conclusion, although a range of events precede the onset of FND, they do not appear to do so uniformly. This may support a different aetiological role for stressors than in other disorders, although the support is indirect and the quality generally low.

Conversion Disorder in a Pharmacogenomics, Polypharmacy Patient: Case Report

Background: Conversion disorder (CD) is a relatively common psychiatric disorder likely encountered by clinical pharmacists but probably not easily identified by pharmacists. Case Summary: This is a patient case where a patient with a tremor was referred to the pharmacist led, polypharmacy, pharmacogenomics (PGx) service to rule out a PGx cause due to medication metabolism. No pharmacologic or PGx cause was found for the tremor which helped support and confirm a diagnosis of CD. Practice Implications: By working collaboratively with psychiatrists, neurologists, physical medicine colleagues, clinical pharmacists may add value to patient care by assisting with diagnoses and appropriate treatment.

Algoneurodystrophy in a Patient with Major Depressive Disorder

Introduction. Not infrequently, in patients with a psychiatric illness who have concomitant physical symptoms, these symptoms are often wrongly attributed to a psychiatric illness. Consequently, there is a delay in establishing the correct diagnosis, which may have an impact on the prognosis of the disease. The authors aim to present a case report of a patient with a diagnosis of major depressive disorder and conversion disorder that was later correctly diagnosed with algoneurodystrophy. The authors intend to draw attention to the importance of a careful medical history and this entity. Case Presentation. A patient went to the emergency department multiple times with complaints of decreased strength and pain in the right upper limb, concomitantly with depressive symptoms. The patient was first diagnosed with conversion disorder and major depressive disorder. After the worsening of the clinical condition with the appearance of neuropathic pain and the exclusion of other organic pathologies, the probable diagnosis of algoneurodystrophy was made. At that time, the patient started treatment and a favorable clinical evolution was observed. Discussion. The clinical case highlights the importance of conducting a careful medical history in a patient with a psychiatric illness, so as not to mistakenly exclude the presence of an organic disease. The absence or delay in making a correct diagnosis can have adverse consequences in terms of the prognosis of the disease.

Colour Vision Disorder due to Conversion Disorders in Childhood

Background Non-organic vision loss can manifest in various ways, most commonly in the form of reduced vision and visual field defects. Colour vision disorders in the context of a conversion disorder have only rarely been reported. Materials and Methods This review presents the case of a 9-year-old boy with a colour vision disorder as the isolated symptom of a conversion disorder. The challenging in this case was an additional somatic comorbidity – a congenital red-green deficiency. Consequently it was difficult to make a diagnosis and to convince the parents. Conclusion It is important to rule out organic causes and establish the diagnosis of a conversion disorder. In these cases, multidisciplinary treatment is crucial for a successful outcome. The diagnosis may be especially challenging when the patients have both somatic and psychogenic complaints.