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Ten-Year Prognosis of Conversion Disorder

Published online by Cambridge University Press:  02 January 2018

C. J. Mace  and
M. R. Trimble
C. J. Mace*
Affiliation:
Department of Psychology, University of Warwick, Coventry
M. R. Trimble
Affiliation:
Department of Neuropsychiatry, Institute of Neurology, London
*
Dr C. J. Mace, Department of Psychology, University of Warwick, Coventry CV4 7AL
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Abstract

Background

Previous work suggests neurological disease commonly supervenes in cases of conversion disorder but has not identified clear predisposing factors. Patients' subsequent use of services has been neglected.

Method

Clinical outcomes for 73 patients investigated for pseudoneurological symptoms at a neurological hospital 10 years earlier were compared with findings on presentation. Fifty-six patients complied with a structured interview concerning use of services.

Results

Thirty patients had no relief from their original symptom at follow-up. They had been older, with more chronic symptoms, and different auxiliary psychiatric diagnoses. In 11 patients a clear neurological diagnosis was subsequently made for the original symptom. Provisional neurological diagnoses at presentation had been disproportionately common among these 11. Small numbers of patients with poor outcomes made most use of hospital and community services. High attenders met screening criteria for somatisation disorder at follow-up.

Conclusions

The prognosis for chronic symptoms remains poor, but subsequent rediagnosis of neurological disease is less frequent than commonly supposed. Somatisation disorder may develop if hospital contact does not lead to diagnosis of another disease.

Type
Papers
Information
The British Journal of Psychiatry , Volume 169 , Issue 3 , September 1996 , pp. 282 - 288
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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