Article

Somatization and Convension Disorder

Department of Psychiatry, University of British Columbia, Vancouver.
Canadian journal of psychiatry. Revue canadienne de psychiatrie (Impact Factor: 2.55). 04/2004; 49(3):172-8.
Source: PubMed

ABSTRACT

Somatization is the psychological mechanism whereby psychological distress is expressed in the form of physical symptoms. The psychological distress in somatization is most commonly caused by a mood disorder that threatens mental stability. Conversion disorder occurs when the somatic presentation involves any aspect of the central nervous system over which voluntary control is exercised. Conversion reactions represent fixed ideas about neurologic malfunction that are consciously enacted, resulting in psychogenic neurologic deficits. Treatment is complex and lengthy; it includes recovery of neurologic function aided by narcoanalysis and identification and treatment of the primary psychiatric disorder, usually a mood disorder.

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    • "Hysterical paralysis, or conversion motor disorder, is a rare condition sometimes seen after spinal surgery [4]. Motor loss in a non-anatomic topographic distribution develops suddenly, shortly after a triggering event responsible for psychological distress [5] [6]. When this event is a surgical procedure, the diagnosis is particularly challenging. "

    No preview · Article · Sep 2015 · Revue de Chirurgie Orthopédique et Traumatologique
    • "Hysterical paralysis, or conversion motor disorder, is a rare condition sometimes seen after spinal surgery [4]. Motor loss in a non-anatomic topographic distribution develops suddenly, shortly after a triggering event responsible for psychological distress [5] [6]. When this event is a surgical procedure, the diagnosis is particularly challenging. "
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    ABSTRACT: We report a case of conversion paralysis after cervical spine arthroplasty performed in a 45-year-old woman to treat cervico-brachial neuralgia due to a left-sided C6-C7 disc herniation. Upon awakening from the anaesthesia, she had left hemiplegia sparing the face, with normal sensory function. Magnetic resonance imaging (MRI) of the brain ruled out a stroke. MRI of the spinal cord showed artefacts from the cobalt-chrome prosthesis that precluded confident elimination of mechanical spinal cord compression. Surgery performed on the same day to substitute a cage for the prosthesis ruled out spinal cord compression, while eliminating the source of MRI artefacts. Findings were normal from follow-up MRI scans 1 and 15days later, as well as from neurophysiological testing (electromyogram and motor evoked potentials). The deficit resolved fully within the next 4days. A psychological assessment revealed emotional distress related to an ongoing divorce. The most likely diagnosis was conversion paralysis. Surgeons should be aware that conversion disorder might develop after a procedure on the spine, although the risk of litigation requires re-operation. Familiarity with specific MRI sequences that minimise artefacts can be valuable. A preoperative psychological assessment might improve the detection of patients at high risk for conversion disorder. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
    No preview · Article · Jul 2015 · Orthopaedics & Traumatology Surgery & Research
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    • "Malingering is the intentional amplification of cognitive and/or emotional symptoms for secondary gain. Conversion disorders, however, are the result of unintentional symptom amplification for psychological reasons (Hurwitz, 2004). Since neither condition is the result of an organic impairment (Boone & Lu, 1999), a major differentiating factor is one of intentionality (Sellbom, Wygant, & Bagby, 2012). "
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    ABSTRACT: This study examined differences in raw scores on the Symptom Validity Scale and Response Bias Scale (RBS) from the Minnesota Multiphasic Personality Inventory-2 in three criterion groups: (i) valid traumatic brain injured, (ii) invalid traumatic brain injured, and (iii) psychogenic non-epileptic seizure disorders. Results indicate that a >30 raw score cutoff for the Symptom Validity Scale accurately identified 50% of the invalid traumatic brain injured group, while misclassifying none of the valid traumatic brain injured group and 6% of the psychogenic non-epileptic seizure disorder group. Using a >15 RBS raw cutoff score accurately classified 50% of the invalid traumatic brain injured group and misclassified fewer than 10% of the valid traumatic brain injured and psychogenic non-epileptic seizure disorder groups. These cutoff scores used conjunctively did not misclassify any members of the psychogenic non-epileptic seizure disorder or valid traumatic brain injured groups, while accurately classifying 44% of the invalid traumatic brain injured individuals. Findings from this preliminary study suggest that the conjunctive use of the Symptom Validity Scale and the RBS from the Minnesota Multiphasic Personality Inventory-2 may be useful in differentiating probable malingering from individuals with brain injuries and conversion disorders.
    Full-text · Article · Mar 2013 · The Clinical Neuropsychologist
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