Before you diagnose a patient with a conversion disorder, perform a thorough general medical and neurological examination. Case study
Journal Title: Psychiatria Polska - Year 2012, Vol 46, Issue 3
Abstract
Introduction. Dissociative and conversion disorders are classified together according to ICD-10 as states that are not confirmed by the presence of somatic diseases, which they suggest. According to the DSM-IV, both disorders are classified separately. Conversion disorders are a group of psychiatric disorders whose symptoms mimic the presence of malfunction or loss of motor or sensory function, whereas the nature and dynamics of the observed symptoms is not fully explained by the results of objective assessments and consultations, nor is the direct effect of a psychoactive substance. Impaired mental integration of different functions which normally interact simultaneously in the perception of reality and inner experience of the individual is found in dissociative disorders. Aim. The article describes the case of 25-year old man, in whom after initial suspicion of myasthenia gravis and its exclusion, a diagnosis of conversion disorder was made on the basis of the clinical picture and treatment with an SSRI antidepressant and individual psychotherapy were recommended. No improvement in mental and neurological status after six month therapy resulted in an in-depth diagnostics in a clinical setting and diagnosis of brain stem tumor (aastrocytoma fibrillare). Conclusions. (a) Neuroimaging is a source of important clinical data and in many cases should constitute an inherent element of a psychiatric diagnosis. (b) Diagnosis of conversion (dissociative) disorders requires a precise differential diagnosis, excluding the somatic causes of observed neurological ailments. (c) A late diagnosis of neurological or somatic causes of symptoms which arouse a suspicion of conversion (dissociative) disorders may make a radical treatment impossible or may considerably aggravate the remote prognosis and quality of the patients’ life.
Authors and Affiliations
Tomasz Pawełczyk, Agnieszka Pawełczyk, Jolanta Rabe-Jabłońska
Keywords
Related Articles
- EP ID EP156148
- DOI -
- Views 82
- Downloads 0
Specyfika uczenia się materiału słownego, wzrokowo-przestrzennego oraz proceduralnego w wariancie Richardsona postępującego porażenia ponadjądrowego w porównaniu z chorobą Parkinsona
Cel pracy Postępujące porażenie ponadjądrowe (PSP) jest klasyfikowane w ramach spectrum atypowych zespołów parkinsonowskich lub też zwyrodnienia czołowo-skroniowego. Praca miała na celu porównanie profili uczenia się mat...
Polski Test Czytania Słów dla Dorosłych (PART) – konstrukcja polskiego testu do pomiaru poziomu inteligencji przedchorobowej w schizofrenii
Cel pracy Ze względu na niedostępność na rynku polskim standaryzowanych metod do pomiaru PII, celem pracy była konstrukcja polskiego testu do oceny poziomu inteligencji przedchorobowej - PART (Polish Adult Reading Test)...
Gender-related differences in social support program for mentally ill persons
Aim. The current study is a part of a research program on schizophrenia course in the system of community based assistance and support for mentally ill persons who do not use regular mental health system. The aim of this...
Prevalence of mental disorders and psychoactive substance use in metropolitan 17-year old youth population
Aim. To determine the extent to which mental disorders (depressive disorders, anxiety disorders, eating disorders) and psychoactive substance use are prevalent among Krakow secondary school adolescents in the late adoles...
Correlations between working memory effectiveness and depression levels after pharmacological therapy
Aim. The goal of the study was to identify possible associations between spatio-visual performance and verbal working memory, evaluated on admission, with the remission degree, assessed by the HDRS after 8-week pharmacot...