The relationship between psychosocial trauma type and conversion (functional neurological) disorder symptoms: a cross-sectional study

Abstract

Objective: Psychosocial trauma was associated with developing conversion disorder (also known as functional neurological disorder) before Freud, though why a particular symptom should arise is unknown. We aimed to determine if there was a relationship between trauma type and symptom. Methods: We retrospectively reviewed the medical records of patients attending Australia’s first functional neurology clinic, including referral, clinic letters and a clinic questionnaire. Results: There were 106 females, 43 males and five transgender patients. Sensory (51%), motor (47%) and seizures (39%) were the commonest functional symptoms. Most patients (92%) reported stressors associated with symptom onset. Multiple trauma/symptom type associations were found: patients with in-law problems experienced more cognitive symptoms ( p = .036), for example, while expressive speech problems more commonly followed relationship difficulties ( p = .021). Conclusion: Associations were found between type of traumatic events and type of symptoms in conversion disorder. This will require verification in a larger sample.

Research Letter: Functional neurological disorder in transgender people: A case series

“…Medical records on all transgender people seen in a public FND clinic in Melbourne (Morsy et al., 2021) were obtained and compared with the clinic’s other patients. Comparisons were made using chi-square tests, unless indicated.…”

“…There is a marked difference between the genders in the prevalence of functional neurological disorder (FND). Though no longer considered an exclusively female malady, women are at least twice as likely to develop FND (Morsy et al., 2021). The reasons behind this are unknown, with biological, cultural and social explanations suggested (Chouksey and Pandey, 2020).…”

“…Unfortunately, gender diversity has been largely overlooked in FND studies (Lidstone et al., 2022). However, high levels of other mental disorders are reported in the transgender population, including somatoform disorders (Lidstone et al., 2022), and transgender people have presented to our FND clinic (Morsy et al., 2021). This paper aims to characterise the transgender patients with FND seen in our clinic to further explore the intersection between the two and to obtain a first approximation of how commonly this occurs.…”

A Case Series of Transgender and Gender-Nonconforming Patients in a Pediatric Functional Neurologic Disorder Clinic

“…One cross-sectional study of an Australian adult FND clinic found a higher proportion of TGNC patients than would be expected based on census data, although the authors speculated that there may have been an underrepresentation of TGNC individuals in the census. 38 A case report from Israel described an adolescent who presented with dense hemiparesis, hemisensory loss, and unilateral diminished reflexes that mimicked an acute stroke. 39 These symptoms occurred during a period of “severe emotional stress while questioning his gender identity.” Orfanelli and Borkowski detailed their care of a 10-year-old transgender boy with FND.…”

The genetic and somatic expressions of trauma: A review of pathology and treatment

“…PTSD is the result of vulnerable genetics and less-than-optimal events of fate. i.e., biography informs and impacts the response of biology (Morsy et al, 2021). The comprehensive study of stress and trauma has origins in the field of physics, with the earliest research being conducted by stress research pioneer Hans Seyle (1965).…”