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Conversion Disorder Presentation (Signs and Symptoms (Pt believes the…
Conversion Disorder Presentation
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Title Page
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Table of contents
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I chose this disorder because I can't stand the unknown. One of my OCD anxiety triggers is the fear/obsession of the unknown. I have an obsession to understand why this occurs and what effects it has on the body and why the body and mind could torture someone in such a way
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Definitions
Pts believe the symptoms are true
Example: changing 3ft into 36in or 1yd. Changing one form into another but the value doesn't change
Sounds complicated because it is
The way it works is not as easy to explain as its definition
partial or complete memory loss of the normal integration between memories of the past awareness of identity and immediate sensations and control of bodily movements
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Somatoform disorders are not based on theoretical construct or laboratory findings and there is no significant substantiating data, but yet there are vigorous and sincere complaints, "not imaginary"
You have symptoms that dont make sense with any medical condition
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How its diagnosed: Characterized by 6 symptoms
Causes
Takes one emotion and turns into a physical display, you display what you feel
How is this possible? There is no good explanation for it. Your brain cant handle the emotion so it tries to relieve the tension by physically releasing it.
1-2 neurological symptoms that effect either the voluntary or sensory nervous systems
Traumatic event at some point in the persons life
Underlying psychological issues
Signs and Symptoms
Pt believes the symptoms are true
The list is endless...Most common are...
Psychologenic non-epileptic seizure: its a seizure which is not neurological and is generally associated with other psychological problems
Black outs
Shaking
Paralysis
Deficits in motor and sensory function
impaired balance
weakness
loss of sensation
deafness
difficulty swallowing
periods of unresponsiveness
speech problems
History
How does EMS assess this patient
They are not mentally ill, incompetent, or crazy
There are people out there who fake it to create drama and seek attention. They make it hard for the people who do have it to not get labeled as a faker.
Alot of these people feel alone and and think people dont know how they feel.
Long term treatment
Psychotherapy
Teach coping skills
Amobarbital interview(truth serum) help pts remember and tell the truth
Due to the lack of knowledge its hard to treat. Its been reported that epilepsy and other seizure disorders have an exponentially better success rate.
Group therapy, support groups; experienceproject.com
Couseling
Prescriptions for anxiety and depression
Sometimes its successful and and the disorder is eliminated, but most of the time its a life long struggle but can get better and more controlled. On rare occasions its ineffective with no progress.
Hypnosis
Trustful and supportive relationship with your Doctor
Build a relationship with the pt
Associated with other disorders
Passive aggressive disorder
Dependent disorder
Antisocial personality disorder(pts <18yo=conduct disorder)
Histrionic personality disorder
Interesting facts
Most unique
Not common currently, but is up and coming
Affects children all the way up to the average age of 36yo
Approximately 95% of acute cases remit spontaneously, usually within 2 weeks in hospitalized pts
Recurrence occurs in 1/5 to 1/4 of people within 1 year of the first episode
Approximately 75% of patients will experience spontaneous resolution and 25% of patients will experience recurrence of the same or different conversion symptoms at a 15-year follow-up.
Accounts for 1.2%-11.5% of psychiatric consultations for hospitalized medical and surgical pts in america
Internationally in Iceland 15 out of every 100,000 pts are diagnosed with CD
Study of psychogenic non epileptic seizure over a 5-year period showed 47% of patients were unemployed, 26% were not living independently, and only 16% were seizure free at 21 months post diagnosis of psychogenic nonepileptic seizure.
Sources
https://rarediseases.org/rare-diseases/conversion-disorder/
http://www.mayoclinic.org/diseases-conditions/conversion-disorder/basics/definition/con-20029533
http://emedicine.medscape.com/article/805361-overview
