Assessment of the patients diagnosed with conversion disorder in the emergency department

Abstract

Aim: Conversion disorder is defined as a specific disorder that accompanies the psychological conflict, has one or more neurological symptoms and in which there is a loss of bodily functioning that would seem to a physical disturbance. The aim of this study was to determine the ratio of the patients diagnosed with conversion disorder to all patients in the emergency department and to investigate the sociodemographic and clinical characteristics of the patients, attitudes and treatment approaches of the physicians. Material and Method: This cross sectional, retrospective study was conducted at a governmental secondary care hospital. After approval from the ethics committee, data pertaining to patients aged at least 18 years who had presented to the ED with various symptoms and had diagnosis of conversion was studied between July 1 and December 31, 2017. The exclusion criteria were as follows: age of less than 18 years, patients with additional pathology besides conversion disorder, patients with a lack of psychiatric consultation and patients whose data cannot be accessed from the system. A p value less than 0.05 was considered statisticallysignificant. Results: A total of 124 patients were included in the study. 71% (n: 88) of the patients were female, 54.8% (n: 68) were single. 17.7% (n = 22) of the patients had comorbid disease.There was a stressor event in all patients before hospital admission. %50 of patients were younger than 23 years. The most common complaint was syncope. 93 patients admitted by ambulance. There was the prior conversion disorder history in 66.1%. Any medical examinations were not required in 61.3% of the patients. The mean elapsed time in all patients was 135 min. Between in patients transported by ambulance and in walk-in patients, there was a statistically significant difference in terms of mean elapsed time between the patients' emergency service admission and discharge from hospital. Conclusion: It was detected that the conversion disorder was more commonly seen in female gender and young age group, the most common complaint of conversion disorder was syncope, most of the patients with conversion disorder had similar complaints before, patients with conversion disorder often preferred to transport to the hospital with ambulance, the patients who received the red code according to the triage code and patients with conversion disorder were examined in almost the same time period and the patients with conversion disorder stayed in emergency department for long hours.