Conversion disorder: A systematic review of current terminology

Ding, Juen Mei; Kanaan, Richard A A

doi:10.1016/j.genhosppsych.2016.12.009

Cited by 29 publications

(17 citation statements)

References 24 publications

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“…Although this term is more acceptable to patients than the term pseudoseizures, 16,18 and popular among neurologists and epileptologists, 17,19 it is nonetheless a "negative" diagnostic term, which focuses on what the patient does not have, rather than giving the patient a positive explanation for their symptoms. Systematic reviews have shown that the most popular term among patients (and clinicians) for conversion disorder is "functional," 21 and studies that have assessed its use in patients specifically with seizure disorders corroborate these findings. 16 However, in this survey, only 28% of GPs used this term.…”

Section: Discussionmentioning

confidence: 98%

Functional seizures: An evaluation of the attitudes of general practitioners local to a tertiary neuroscience service in London

et al. 2018

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Summary Objective Functional seizures are a common functional neurologic disorder. Given their chronic nature, and the biopsychosocial factors involved in their etiology, general practitioners (GPs) play a crucial role in the care of these patients. However, little is known about the attitudes of GPs toward, and knowledge of, functional seizures. Methods The Atkinson Morley Regional Neuroscience Centre in London provides a comprehensive service to patients with functional seizures. As part of a service evaluation we conducted an online survey among local GPs over a 1‐month period assessing their attitudes toward, and knowledge of, functional seizures. Results One hundred twenty of 974 surveyed GPs replied to the survey (12.3%). Approximately 75% of GPs readily use the term “pseudoseizures,” and over 50% were not sure or did not think that functional seizures were involuntary. Nearly 30% believed, or were unsure as to whether, functional seizures occur only when patients are stressed. Despite approximately 50% of GPs expressing interest in getting involved in the management of these patients, a similar proportion do not feel confident in dealing with queries from patients with functional seizures. Although most GPs felt that neurology and psychiatry should be the primary caregivers in the diagnosis and management, respectively, of functional seizures, 50% were also of the opinion that neurology should be involved in the management of these patients. Significance This survey highlights the attitudes of, and descriptive terms used by, GPs toward patients with functional seizures. Our findings suggest a need for better and clearer provision of information to GPs about this condition.

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Section: Discussionmentioning

confidence: 98%

Functional seizures: An evaluation of the attitudes of general practitioners local to a tertiary neuroscience service in London

et al. 2018

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“…The terminology for FNDs has evolved over the centuries, and includes the following: hysteria, psychogenic complaints, dissociative states, neurologically unexplained symptoms, somatoform, and conversion disorder. The currently favored term functional neurological disorder emphasizes how the condition is a disorder of function, not of structure or disease. Major risk factors for FNDs include psychosocial stressors and posttraumatic stress disorder (PTSD) …”

Section: Introductionmentioning

confidence: 99%

Psychogenic non‐epileptic seizures among patients with functional neurological disorder: A case series from a Tanzanian referral hospital and literature review

et al. 2018

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SummaryObjectiveFunctional neurological disorders (FNDs) and psychogenic nonepileptic seizures (PNES) are likely as common in Sub‐Saharan Africa (SSA) as in the rest of the world, but there is a dearth of literature on the epidemiology and clinical presentation of these disorders in Africa. The purpose of this paper is to describe a case series of FNDs presenting to a referral hospital in SSA. In addition, we review the existing literature on FNDs in Africa.MethodsA hospital‐based retrospective cross‐sectional study was conducted to determine the prevalence, epidemiology, and clinical phenotype of FNDs and PNES in a referral hospital in Northern Tanzania over a 6‐year period (2007–2013).ResultsOf 2,040 patients presenting with neurological complaints, 44 (2.2%) were diagnosed with FNDs. Half (n = 22) had the clinical presentation of PNES. Age of presentation for FNDs and PNES peaked in the teen years 12–19 (n = 21 48%; and n = 14, 63%, respectively), and the majority were female (n = 30, 68%; and n = 14, 63%, respectively). The majority presented acutely with short‐lived and self‐limiting symptoms (only 2 recurrent cases). Literature review revealed multiple reports of “mass hysteria” in SSA often meeting the clinical criteria of epidemic FNDs.Significance FNDs and PNES occur in Africa with age and gender distribution comparable to that found elsewhere. Although the percentage of FND cases overall was relatively low (2.2%), it is likely to be an underestimate because not all cases were recorded, and cases may be appropriately managed locally before patients are referred to a hospital. PNES was the most common phenotype of FNDs reported, and the African phenotype may be short‐lived and self‐limiting rather than chronic and recurrent, as reported elsewhere in the world. PNES presentations may also occur in clusters, which may have cultural significance in Africa. FNDs in Africa appear to be underreported, particularly over the last 30 years.

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“…While "psychogenic," "psychosomatic," and "nonorganic" all remain in use, there is growing preference for the word "functional". 9 Within the field of neurology, the term FND is more commonly used than FNSD or conversion disorder, and additional diagnostic labeling is often used to distinguish among different presentations. For example, functional motor disturbances can be referred to as functional movement disorders and can be further subdivided into functional gait disturbance, tremor, dystonia, myoclonus, chorea, and weakness.…”

Section: Overvie W Of Fun C Tional Neurolog Ic Al Disorder Smentioning

confidence: 99%

“…In contrast to the specific language of the DSM‐5, the informal labels given to medically unexplained symptoms remain somewhat heterogeneous. While “psychogenic,” “psychosomatic,” and “nonorganic” all remain in use, there is growing preference for the word “functional” 9 . Within the field of neurology, the term FND is more commonly used than FNSD or conversion disorder, and additional diagnostic labeling is often used to distinguish among different presentations.…”

Section: Overview Of Functional Neurological Disordersmentioning

confidence: 99%

“…Other presentations include functional blindness, aphonia/dysphonia, and sensory changes. Functional seizures are often referred to as psychogenic nonepileptic spells (PNES) 9 . Whether or not these phenotypes represent biologically distinct entities or different manifestations of the same underlying process remains a matter of some controversy, though that individual patients often display multiple types of functional symptoms has been cited by some as evidence of the latter 11 …”

Section: Overview Of Functional Neurological Disordersmentioning

confidence: 99%

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Psychedelic‐assisted therapy for functional neurological disorders: A theoretical framework and review of prior reports

Stewart

Dean

Koek

et al. 2020

Pharmacology Res & Perspec

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Functional neurological disorders (FNDs), which are sometimes also referred to as psychogenic neurological disorders or conversion disorder, are common disabling neuropsychiatric disorders with limited treatment options. FNDs can present with sensory and/or motor symptoms, and, though they may mimic other neurological conditions, they are thought to occur via mechanisms other than those related to identifiable structural neuropathology and, in many cases, appear to be triggered and sustained by recognizable psychological factors. There is intriguing preliminary evidence to support the use of psychedelic‐assisted therapy in a growing number of psychiatric illnesses, including FNDs. We review the theoretical arguments for and against exploring psychedelic‐assisted therapy as a treatment for FNDs. We also provide an in‐depth discussion of prior published cases detailing the use of psychedelics for psychosomatic conditions, analyzing therapeutic outcomes from a contemporary neuroscientific vantage as informed by several recent neuroimaging studies on psychedelics and FNDs.

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Conversion disorder: A systematic review of current terminology

Cited by 29 publications

References 24 publications

Functional seizures: An evaluation of the attitudes of general practitioners local to a tertiary neuroscience service in London

Functional seizures: An evaluation of the attitudes of general practitioners local to a tertiary neuroscience service in London

Psychogenic non‐epileptic seizures among patients with functional neurological disorder: A case series from a Tanzanian referral hospital and literature review

Psychedelic‐assisted therapy for functional neurological disorders: A theoretical framework and review of prior reports

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