engleski

Difficulites in diagnostics and treatment of conversion disorder- experiences from Croatia

Background and aims: Conversion disorder is a mental condition characterized by disruption in voluntary motor or sensor function that can not be explained by neurological nor other general medical condition. Symptoms usually occur after a stressful life event. Our aim was to present a wide range of conversive symptoms that can complicate setting a diagnosis and postpone targeted treatment. Methods: We will present a series of cases of patients with conversion disorder who were hospitalized at the University Psychiatric Hospital Vrapce during 2017 and 2018. Examination included detailed clinical interview with patients and their relatives, blood tests, psychological testing and neurological examination. Results: The diagnosis of conversion disorder often presents a clinical challenge due to a wide range of symptoms that can be misleading and considered as a part of other mental, neurological or somatic disorder. Motor dysfunction and psychogenic non-epileptic seizures are the most common among conversive symptoms. Other important symptoms include sensory symptoms (e.g. apparent loss of all modalities of sensation in limbs) and alexitimia. Conclusions: In cases of patients in emotional crises who present with neurological symptoms that seem to be inconsistent or incompatible with known neurological and somatic diseases, conversion disorder has to be considered as a possible differential diagnosis. As soon as the organic background of the symptoms is excluded, it is necessary to start psychotherapy treatment. Shorter duration of symptoms, emphatic approach and confindence in positive outcome are considered to be good prognostic factors in the treatment of patients with conversion disorders.

conversion disorder ; treatment ; diagnostics

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