Factitious Disorders in Neurology: An Analysis of Reported Cases

Kanaan, Richard A A; Wessely, S. C.

doi:10.1176/appi.psy.51.1.47

Cited by 28 publications

(19 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This pattern in the qualitative study led to the concern that this would lead to changed diagnoses—either as CD cases would be ‘downgraded’ to a ‘simply unexplained’ or as cases of feigning would be allowed to carry the diagnosis of CD or some other unexplained condition 6. The evidence from this survey is that neurologists usually were willing to talk about psychological factors, even when the patient resisted, so the first kind of downgrading seemed likely to be rare; the concern about feigning seemed to be more justified, however, a finding supported by our review11 of published cases of factitious neurology which suggested the bulk of them may be diagnosed as CD.…”

Section: Discussionsupporting

confidence: 60%

Neurologists' understanding and management of conversion disorder

Kanaan

Armstrong

Wessely

2011

Journal of Neurology, Neurosurgery & Psychiatry

Self Cite

View full text Add to dashboard Cite

BackgroundConversion disorder is largely managed by neurologists, for whom it presents great challenges to understanding and management. This study aimed to quantify these challenges, examining how neurologists understand conversion disorder, and what they tell their patients.MethodsA postal survey of all consultant neurologists in the UK registered with the Association of British Neurologists.Results349 of 591 practising consultant neurologists completed the survey. They saw conversion disorder commonly. While they endorsed psychological models for conversion, they diagnosed it according to features of the clinical presentation, most importantly inconsistency and abnormal illness behaviour. Most of the respondents saw feigning as entangled with conversion disorder, with a minority seeing one as a variant of the other. They were quite willing to discuss psychological factors as long as the patient was receptive but were generally unwilling to discuss feigning even though they saw it as their responsibility. Those who favoured models in terms of feigning were older, while younger, female neurologists preferred psychological models, believed conversion would one day be understood neurologically and found communicating with their conversion patients easier than it had been in the past.DiscussionNeurologists accept psychological models for conversion disorder but do not employ them in their diagnosis; they do not see conversion as clearly different from feigning. This may be changing as younger, female neurologists endorse psychological views more clearly and find it easier to discuss with their patients.

show abstract

Section: Discussionsupporting

confidence: 60%

Neurologists' understanding and management of conversion disorder

Kanaan

Armstrong

Wessely

2011

Journal of Neurology, Neurosurgery & Psychiatry

Self Cite

View full text Add to dashboard Cite

show abstract

“…Ultimately, we do not know how common feigning in neurology is, for the reasons given above. We know it does rarely occur,93 that it can occur in cases that were previously diagnosed as conversion disorder (commonly as a result of surveillance evidence being produced in court) and it is inevitable that some—possibly most—cases go undetected, or unreported 66. Feigning, therefore, is a possible explanation for conversion disorder, and one that undoubtedly explains a small minority of cases, but it is not a distinction that appears to have clinical utility.…”

Section: Is Conversion Disorder Different To Feigning?mentioning

confidence: 99%

Conversion disorder: a problematic diagnosis

Nicholson¹,

Stone

Kanaan

2010

Journal of Neurology, Neurosurgery & Psychiatry

View full text Add to dashboard Cite

“…No matter how we as clinicians may wish to acclaim CD as a disorder ‘like any other’, one which may be understood in terms of information processing and attentional biases,12 or drawing on the latest neuroscience technology, a reaction to stress, or the manifestation of a mental disturbance in the physical domain,13 it is hard if not impossible to separate it from a moral/volitional context 14. There are other lessons: moving away from ‘miraculous cures’, these cases might encourage clinicians to believe that patients with CD have the potential to recover even after years of functional impairment.…”

Section: The Diagnosis Of Cd/fnsmentioning

confidence: 99%