Specialist inpatient treatment for severe motor conversion disorder: a retrospective comparative study

J Neurol Neurosurg Psychiatry. 2014 Aug;85(8):895-900. doi: 10.1136/jnnp-2013-305716. Epub 2013 Oct 11.

Abstract

Background: Gold standard protocols have yet to be established for the treatment of motor conversion disorder (MCD). There is limited evidence to support inpatient, multidisciplinary intervention in chronic, severe cases.

Aims: To evaluate the characteristics and outcomes of MCD patients admitted to a specialist neuropsychiatric inpatient unit.

Methods: All patients admitted to the Lishman Unit (years 2007-2011) with a diagnosis of MCD were included. Data relevant to characteristics and status with regard to mobility, activities of daily living (ADLs) and Modified Rankin Scale (MRS) score at admission and discharge were extracted.

Results: Thirty-three cases (78.8% female) were included; the median duration of illness was 48 months. In comparison with brain injury patients admitted to the same unit, more cases had histories of childhood sexual abuse (36.4%, n=12), premorbid non-dissociative mental illness (81.1%, n=27) and employment as a healthcare/social-care worker (45.5%, n=15). Cases showed significant improvements in MRS scores (p<0.001), mobility (p<0.001) and ADL (p=0.002) following inpatient treatment.

Conclusions: Patients with severe, long-standing MCD can achieve significant improvements in functioning after admission to a neuropsychiatry unit.

Keywords: MOVEMENT DISORDERS; NEUROPSYCHIATRY; REHABILITATION.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Chronic Disease
  • Cognitive Behavioral Therapy
  • Comorbidity
  • Conversion Disorder / complications
  • Conversion Disorder / psychology
  • Conversion Disorder / therapy*
  • Data Interpretation, Statistical
  • Female
  • Humans
  • Inpatients
  • International Classification of Diseases
  • Male
  • Mental Disorders / complications
  • Middle Aged
  • Predictive Value of Tests
  • Psychiatry
  • Retrospective Studies
  • Risk Factors
  • Specialization
  • Treatment Outcome
  • Young Adult