Early intervention for conversion disorder: neurologists and psychiatrists working together

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

doi:10.1111/j.1601-5215.2012.00668.x

Cited by 21 publications

(19 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of interest, a significant number of patients accepted psychiatric referral in our study, independently of the group allocation. This finding is in concordance with results of our retrospective study where 73%-83% of patients with conversion disorder accepted psychiatric referral [25]. It must be pointed out that both groups benefited from meetings with the psychiatrist and the neurologist for the diagnosis restitution (which is standard care in our center since 2005) and the 2-, 6-and 12-month evaluations.…”

Section: Discussionsupporting

confidence: 94%

“…The evidence of an association between childhood trauma and conversion disorder being meanwhile strong [23,24], we integrated basic psychotraumatology principles in our psychotherapeutic intervention, hoping to increase patients' treatment adherence. A retrospective study showed that such early intervention involving both neurologists and psychiatrists was effective in reducing physical symptoms, sick leave and health care use [25]. There are only very few published data on the efficacy of therapeutic interventions for conversion disorders [26].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of brief interdisciplinary psychotherapeutic intervention for motor conversion disorder and nonepileptic attacks

Hubschmid

Aybek

Maccaferri

et al. 2015

General Hospital Psychiatry

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Efficacy of brief interdisciplinary psychotherapeutic intervention for motor conversion disorder and nonepileptic attacks

Hubschmid

Aybek

Maccaferri

et al. 2015

General Hospital Psychiatry

View full text Add to dashboard Cite

“…Treatments can include early intervention with neurology and psychiatry working together [15], focusing on specific symptoms such as cognitive behavioural therapy (CBT) for dissociative episodes [14,16], physiotherapy for functional movement disorders [17,18] or 1-week multidisciplinary (MDT) programmes for functional movement disorders (physical, occupational, psychotherapy, SALT) [19,20]. More complex and heterogenous symptom presentations often with co-morbidities and high levels of disability, have been referred to MDT (multidisciplinary team)-based programmes which have been delivered in inpatient neuropsychiatric settings [21,22].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of a 5-week individualised MDT outpatient (day-patient) treatment programme for functional neurological symptom disorder (FNSD)

et al. 2020

View full text Add to dashboard Cite

Aim We report results from a 5-week MDT treatment programme, with individualised sessions, for a selected group of patients with FNSD, delivered in a neuropsychiatric outpatient setting. Primary aims were to (1) reduce symptoms, (2) improve functional performance and (3) improve health status. Methods Treatment involved individual sessions of neuropsychiatry, cognitive behavioural therapy, physiotherapy, occupational-therapy, education and family meetings. Outcome measures collected at the beginning and end of treatment and at 6 months, were patient and clinician reported. Aims were assessed by the following: symptom reduction (PHQ15, PHQ9, GAD7, SPIN, Rosenberg); health and social functioning (HONOS, WSAS); functional performance (COPM); health status (EQ-5D-5L) and patient-rated perception of improvement (CGI). Results Analyses of 78 patients completing the programme and attending a 6-month review revealed high-baseline levels of disability compared to EQ-5DL population norms and high rates of disability and psychopathology as indicated by the WSAS and mental health indices (PHQ9, GAD7, SPIN, Rosenberg's self-esteem). At baseline, 92.3% met the IAPT caseness threshold for depression and 71% met the IAPT caseness threshold for anxiety. A Friedman ANOVA over the three time points and Dunn-Bonferroni post hoc tests indicated statistically significant improvements from admission to discharge and admission to 6-month follow-up. Sustained improvements were seen in somatic symptoms (PHQ15), depression (PHQ9), anxiety (GAD7), health and social functioning (HONOS), functionality (COPM), health status (EQ-5D-5L) and patient-rated clinical global improvement (CGI). Conclusion An MDT can effectively deliver an outpatient programme for FNSD which can serve as an alternative to costlier inpatient programmes. Early identification and treatment of co-morbidities is advised.

show abstract

“…Psychiatric evaluation is important, as many FMD patients also suffer from psychiatric comorbidities such as anxiety and/or depression, but often only accepted with a good alliance with the patient [93].…”

Section: Treatment and Outcomementioning

confidence: 99%

Functional movement disorders

et al. 2020

View full text Add to dashboard Cite

Purpose of reviewThe review highlights the clinical presentation of functional movement disorders (FMDs) and presents current evidence on bedside signs and paraclinical tests to differentiate them from other neurological disorders. Recent findingsFMDs are diagnosed by the presence of positive clinical signs as emphasized in the new Diagnostic and Statistical Manual of Mental Disorders-5 classification criteria. Bedside signs are numerous, and a subset of them has been validated in controlled studies. This review summarizes evidence from the literature on specificity and sensibility of positive clinical signs for FMDs. The value of rule-in paraclinical tests to confirm the diagnosis is also presented. Recent developments in neuroscience with pathophysiological mechanisms and current treatment strategies are also discussed. SummaryFMDs represent a field of neurology that is currently rapidly growing in terms of research. Clinicians should be aware that highly reliable signs exist for the diagnosis and that early multidisciplinary treatment should be offered.

show abstract

Early intervention for conversion disorder: neurologists and psychiatrists working together

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

Cited by 21 publications

References 20 publications

Efficacy of brief interdisciplinary psychotherapeutic intervention for motor conversion disorder and nonepileptic attacks

Efficacy of brief interdisciplinary psychotherapeutic intervention for motor conversion disorder and nonepileptic attacks

Outcomes of a 5-week individualised MDT outpatient (day-patient) treatment programme for functional neurological symptom disorder (FNSD)

Functional movement disorders

Contact Info

Product

Resources

About