Læknablaðið - 15.04.2009, Síða 28

F R Æ Ð I G R E I
Y F I R L I T
N A R
14. Sagduyu A, Rezaki M, Kaplan I, et al. Prevalence of
conversion symptoms in a primary healthcare center. Turkish
J Psychiatry 1997; 8:161-9.
15. Heruti RJ, Levy A, Adunski A, Ohry A. Conversion motor
paralysis disorder: overview and rehabilitation model. Spinal
Cord 2002; 40: 327-34. Review.
16. Sar V, Akyuz G, Kundakci I, et al. Childhood trauma,
dissociation, and psychiatric comorbidity in patients with
conversion disorder. Am J Psychiatry 2004; 161: 2271-6.
17. Stone J, Smyth R, Carson A, Warlow C, Sharpe M. La
belle indifference in conversion symptoms and hysteria:
systematic review. Br J Psychiatry 2006; 188: 204-9. Review.
18. Binzer M, Andersen PM, Kullgren G: Clinical characteristics
of patients with motor disability due to conversion disorder:
a prospective control group study. J Neurol Neurosurg
Psychiatry 1997; 63: 83-8.
19. Adams & Victor's Principles of Neurology. Edit: Ropper,
Allan H; Brown, Robert H. McGraw-Hill, 8th Edition, 2005.
20. Roelofs K, Keijsers GPJ, Hoogduin KAL, Moene FC.
Childhood abuse in patients with conversion disorder. Am J
Psychiatry 2002; 159:1908-13.
21. Heafeiz HB. Hysterical conversion: a prognostic study. Br J
Psychiatry 1980; 136: 548-51.
22. Shorter E. From paralysis to fatigue: A history of
psychosomatic illness in the modem era. The Free Press, New
York 1992.
23. Black DN, Seritan AL, Taber KH, Hurley RA. Conversion
hysteria: lessons from functional imaging. J Neuropsychiatry
Clin Neurosci 2004; 16: 245-51.
24. Spence SA, Crimlisk HL, Cope H, Ron MA, Grasby PM.
Discrete neurophysiological correlates in prefrontal cortex
during hysterical and feigned disorder of movement. Lancet
2000; 355:1243-4.
25. Mailis-Gagnon A, Giannoylis I, Downar J, et al. Altered
central somatosensory processing in chronic pain patients
with „hysterical" anesthesia. Neurology 2003; 60:1501-7.
26. Stone J, Zeman A, Simonotto E, et al. FMRI in patients with
motor conversion symptoms and controls with simulated
weakness. Psychosom Med 2007; 69: 961-9.
27. Marshall JC, Halligan PW, Fink GR, Wade DT, Frackowiak
RS. The functional anatomy of a hysterical paralysis.
Cognition 1997; 64: B1-B8.
28. Halligan PW, Athwal BS, Oakley DA, Frackowiak RS.
Imaging hypnotic paralysis: implications for conversion
hysteria (letter). Lancet 2000; 355: 986-7.
29. Yazící KM, Kostakoglu L. Cerebral blood flow changes in
patients with conversion disorder. Psychiatry Res 1998; 83:
163-8.
30. Stonnington CM, Barry JJ, Fisher RS. Conversion disorder.
Am J Psychiatry 2006; 163:1510-7.
31. Okun MS, Koehler PJ. Paul Blocq and (psychogenic) astasia
abasia. Mov Disord 2007; 22:1373-8.
32. Werring DJ, Weston L, Bullmore ET, Plant GT, Ron MA.
Functional magnetic resonance imaging of the cerebral
response to visual stimulation in medically unexplained
visual loss. Psychol Med 2004; 34: 583-9.
33. Slater ET. Diagnosis of 'hysteria'. BMJ 1965; i: 1395-9.
34. Stone J, Smyth R, Carson A, et al. Systematic review of
misdiagnosis of conversion symptoms and "hysteria". BMJ
2005; 331: 989. Review.
35. Moene FC, Landberg EH, Hoogduin KA, et al. Organic
syndromes diagnosed as conversion disorder: identification
and frequency in a study of 85 patients. J Psychosom Res
2000; 49: 7-12.
36. McCahill ME. Somatorm and related disorders: delivery of
diagnosis as first step. Am Fam Physician 1995; 52:193-204.
37. Goldstein LH, Deale AC, Mitchell-O'Malley SJ, Toone BK,
Mellers JD. An evaluation of cognitive behavioral therapy
as a treatment for dissociative seizures: a pilot study. Cogn
Behav Neurol 2004; 17: 41-9.
38. Gabbard GO. Dissociative disorders, in Psychodynamic
Psychiatry in Clinical Practice, 4th ed. American Psychiatric
Publishing, Washington DC 2005: 283-312.
39. Moene FC, Spinhoven P, Hoogduin KA, van Dyck R. A
randomized controlled clinical trial of a hypnosis-based
treatment for patients with conversion disorder, motor type.
Int J Clin Exp Hypn 2003; 51: 29-50.
40. Moene FC, Spinhoven P, Hoogduin KA, van Dyck R. A
randomised controlled clinical trial on the additional effect
of hypnosis in a comprehensive treatment programme for
in-patients with conversion disorder of the motor type.
Psychother Psychosom 2002; 71: 66-76.
41. LaFrance WC Jr, Barry JJ. Update on treatments of
psychological nonepileptic seizures. Epilepsy Behav 2005; 7:
364-74.
42. Voon V, Lang AE. Antidepressant treatment outcomes of
psychogenic movement disorder. J Clin Psychiatry 2005; 66:
1529-34.
43. Möller AL, Stefánsson SB. Segulörvun heila. Læknablaðið
2004; 90: 755-8.
44. Schonfeldt-Lecuona C, Connemann BJ, Spitzer M, Herwig U.
Transcranial magnetic stimulation in the reversal of motor
conversion disorder. Psychotherapy Psychosom 2003; 72:
286-8.
45. Heruti RJ, Reznik J, Adunski A, Levy A, Weingarden H,
Ohry A. Conversion motor paralysis disorder: analysis of 34
consecutive referrals. Spinal Cord 2002; 40: 335-40. Review.
>■
CC
<
2
2
D
cn
x
cn
o
z
LU
Conversion disorder - review
ln modern medicine the term “functional symptoms”
is usually used to refer to symptoms where an organic
cause cannot be found. Studies have shown that up to
half of all patients consulting their family physician and
approximately one third of all those attending neurology
outpatient clinics present with such symptoms. These
patients commonly go between doctors, repeatedly
undergo unnecessary tests, even surgery, and various
drugs are tried with limited success. These problems
tend to be prolonged and greatly reduce the quality
Sveinsson OA, Stefansson SB, Hjaltason H
Conversion disorder - review. Icel Med J 2009; 95: 269-76
of life for the patients involved. Both the DSM IV and
ICD 10 classifications include a group for the so-called
medically unexplained disorders. Among these disorders
is conversion disorder where patients present with
neurological symptoms, affecting motor or sensory
function, but with no neurological explanation. Here we
provide an overview of the current ideas on the aetiology,
diagnosis, treatment and prognosis of conversion disorder.
Keywords: conversion disorder, functional symptoms, functional MRI, rehabilitation
Correspondence: Ólafur Sveinsson olafur.sveinsson@karolinska.se
Barst: 29. október 2008, - samþykkt til birtingar: 18. febrúar 2009.
276 LÆKNAblaðið 2009/95