Psychosocial interventions for conversion and dissociative disorders in adults

Ganslev, Christina A; Storebø, Ole Jakob; Callesen, Henriette E; Ruddy, Rachel; Søgaard, Ulf

doi:10.1002/14651858.cd005331.pub3

Cited by 25 publications

(11 citation statements)

References 213 publications

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“…Given the link between childhood trauma and dissociation in BD, a sensitive inquiry into possible childhood abuse or neglect should be made when patients are clinically stable. Finally, when there are significant DS or a syndromal DD, appropriate psychological interventions should be provided ( 59 ).…”

Section: Discussionmentioning

confidence: 99%

Dissociative Symptoms and Disorders in Patients With Bipolar Disorders: A Scoping Review

Rajkumar

2022

Front. Psychiatry

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Dissociative disorders are an important group of trauma-related disorders associated with significant disability. The co-occurrence of dissociative disorders (DD) and symptoms (DS) in bipolar disorder has been relatively understudied, but there is some evidence that this comorbidity may have significant mechanistic and clinical implications. This paper presents the results of a scoping review of the frequency and correlates of DS and DD in bipolar disorder. Based on the available evidence, DS/DD are more common in bipolar disorder than in healthy controls or in unipolar depression, are related to childhood trauma, and are associated with psychotic symptoms, suicide attempts, and a poorer response to treatment in patients with bipolar disorder. The implications of these findings, and possible mechanistic pathways underlying them, are discussed based on the current literature. Clinicians should be aware of the frequent occurrence of significant DS or DD when treating patients with bipolar disorder. A tentative future research agenda for this field, based on clinical, risk factor-related and neurobiological considerations, is outlined.

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Section: Discussionmentioning

confidence: 99%

Dissociative Symptoms and Disorders in Patients With Bipolar Disorders: A Scoping Review

Rajkumar

2022

Front. Psychiatry

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“…Elevated responsiveness to hypnotic suggestions has been shown to predict treatment outcome in clinical applications of hypnosis (Montgomery et al, 2011) and there is some evidence that hypnotic techniques may be valuable in treating FND (Deeley, 2016b;Sanyal et al, 2021), although the quality of the evidence in this area precludes firm conclusions (Ganslev et al, 2020). Insofar as hypnotic suggestibility moderately predicts responsiveness to direct verbal (non-hypnotic) suggestions (Braffman & Kirsch, 1999;Polczyk, 2016;Wieder & Terhune, 2019), patients with DDs and germane conditions may also benefit from the inclusion of verbal suggestions in non-hypnotic treatments.…”

Section: Implications For the Diagnosis And Treatment Of Dissociative...mentioning

confidence: 99%

Hypnotic suggestibility in dissociative and related disorders: A meta-analysis

Wieder¹,

Brown

Thompson³

et al. 2022

Preprint

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Elevated responsiveness to verbal suggestions following a hypnotic induction is hypothesized to represent a predisposing factor for dissociative disorders (DDs) and germane conditions. However, the magnitude of this effect has not been estimated in these populations nor has the potential moderating influence of methodological limitations on effect size variability across studies. This study quantitatively assessed whether patients with DDs, trauma- and stressor-related disorders (TSDs), and functional neurological disorder (FND) display elevated hypnotic suggestibility. A systematic literature search identified 20 datasets. A random-effects meta-analysis revealed that patients displayed greater hypnotic suggestibility than controls, Hedges’s g=0.92 [0.66, 1.18]. Elevated hypnotic suggestibility was observed in all subgroups but was most pronounced in the DDs. Although there was some evidence for publication bias, a bias- corrected estimate of the group effect remained significant. Moderation analyses did not yield evidence for any link between effect sizes and methodological limitations. These results demonstrate that DDs and germane conditions are characterized by heightened hypnotic suggestibility and have implications for the mechanisms, risk factors, and treatment of dissociative psychopathology.

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“…Tolchin et al do not attempt to identify the best intervention to optimize PNES treatment outcome, addressing instead the benefit of including motivational interviewing added to various heterogeneous treatment approaches. There is currently no single therapeutic approach that has been identified as superior to others, and in fact a recent Cochrane review highlights the absence of high‐quality evidence across PNES treatment approaches 6 . Given treatment heterogeneity in this report to which motivational interviewing was added, there should be greater confidence in the ability to generalize across treatment methods.…”

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confidence: 98%

“…There is currently no single therapeutic approach that has been identified COMMENTARY as superior to others, and in fact a recent Cochrane review highlights the absence of high-quality evidence across PNES treatment approaches. 6 Given treatment heterogeneity in this report to which motivational interviewing was added, there should be greater confidence in the ability to generalize across treatment methods. Motivational interviewing was associated with more than a doubling in treatment adherence and decline is PNES frequency, with even greater improvements in quality of life and in complete cessation of PNES.…”

mentioning

confidence: 99%

Motivational interviewing for psychogenic nonepileptic seizures: Meaningful incentives for patient and provider alike

Loring

2020

Epilepsia

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Psychosocial interventions for conversion and dissociative disorders in adults

Abstract: Analysis 2.3. Comparison 2: Inpatient treatment programme plus hypnosis versus inpatient treatment programme, Outcome

Cited by 25 publications

References 213 publications

Dissociative Symptoms and Disorders in Patients With Bipolar Disorders: A Scoping Review

Dissociative Symptoms and Disorders in Patients With Bipolar Disorders: A Scoping Review

Hypnotic suggestibility in dissociative and related disorders: A meta-analysis

Motivational interviewing for psychogenic nonepileptic seizures: Meaningful incentives for patient and provider alike

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