Conversion Disorder (Functional Neurological Symptom Disorder) in Primary Care Mental Health

Abstract

This case report describes the application of a dialectical behavioral therapy-informed psychotherapy approach to treating conversion disorder (functional neurological symptom disorder) with motor dysfunction in a Veterans Administration Health System Primary Care-Mental Health Integration Clinic. "Jane," a 30-year-old veteran, was diagnosed with conversion disorder, major depressive disorder (MDD), and posttraumatic stress disorder (PTSD). She completed 25 sessions of treatment focused on improving emotion regulation and interpersonal skills over an 8-month period. At the end of treatment, Jane demonstrated improved motor ability and clinically significant improvements in her reported symptoms of MDD (per the Patient Health Questionnaire-9) and PTSD (per the PTSD Checklist-Civilian Version). This case report supports the conceptualization of conversion disorder as a function of emotion dysregulation and the application of a dialectical behavior therapy-informed treatment approach.

Cognitive Behavioral Therapy for Foreign Accent Syndrome: A Single-Case Experimental Design

“…Given that psychogenic disorders are typified by physical symptoms that remain medically unexplained (Harwood et al, 2018), these presentations represent a challenge to health care services. Patients often experience protracted difficulties, frequently presenting to medical services (Rancourt & Darkes, 2019), yet derive limited benefit from treatment (Woolfolk & Allen, 2012). Although there is now greater awareness of psychogenic FAS, as evident in the growth in publications of single FAS case studies (e.g., Ashgar & Whitty, 2020; Asogwa et al, 2016; Reddy et al, 2016; Schuh, 2017), there is no clear guidance on how best to treat individuals with psychogenic FAS.…”