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The natural history and attentional correlates of conversion symptoms in neurological patients

Mace, Christopher John; (1998) The natural history and attentional correlates of conversion symptoms in neurological patients. Doctoral thesis (M.D), UCL (University College London). Green open access

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Abstract

Patients with conversion symptoms continue to present a substantial burden to neurologists and to psychiatrists who work in liaison with them. A survey of British neurologists suggested 36,000 of their consultations per annum were for symptoms presumed psychological in origin (Appendix 1). A historical analysis of the concept of hysterical conversion shows it to be 200 years old. Freud's rediscovery of the term 100 years ago led to substantial revision by his analytic followers. Reasons for this, and for constant changes in its use within psychiatric diagnosis, are discussed (Chapter 1). Past studies of the prognosis of conversion symptoms have been crucial for arguments concerning the diagnosis of hysteria and somatisation disorder. A new 10 year follow-up of 79 patients traced 73 of them. Medical reports and interviews indicated the original symptom had not improved in 30 patients, while neurological diagnoses accounting for the presenting symptom had been made in only 11. Symptom persistence was strongly associated with higher levels of consultation through the follow-up period, and with evidence of somatisation disorder at follow-up. Correlations are reported between symptomatic and diagnostic outcome with some initial findings on neurological and psychiatric examination (Chapter 2). Two experimental studies tested hypotheses implicating attentional deficits in the pathogenesis of conversion symptoms. Groups with pseudoepileptic seizures and lower limb weakness of non-organic origin were compared with controls on tests of perceptual span and verbal-manual interference. Although a group with non-organic weakness performed more poorly than other groups on the latter task, the original hypotheses were not upheld (Chapter 3).

Type: Thesis (Doctoral)
Qualification: M.D
Title: The natural history and attentional correlates of conversion symptoms in neurological patients
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest.
Keywords: Biological sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10103156
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