No abstract available.
Conversion Disorder*

No abstract available.
Adaptation, Psychological* ; Conversion Disorder* ; Somatoform Disorders*

No abstract available.
Adaptation, Psychological* ; Conversion Disorder* ; Somatoform Disorders*

Visual conversion reaction is characterized by fluctuating visual acuity and tubular fields in the absence of any organic lesion. It is thought that the environmental and psychological factors contribute to the onset of symptom. Twenty-two cases of visual conversion reactions were evaluated clinically and the results were as follows. 1. Visual conversion reaction is more frequent in females and children and low vision is almost always affected bilaterally. 2. Sixteen cases(72.7%) showed tubular and constricted fields inspite of normal CT and electrophysiologic responses. 3. Of the cases, 86.4%(19/22) had improved their reduced visual acuity to over 0.8 after treatment with suggestion, placebo, plano lenses and some kind of psychotheraphy.
Child ; Conversion Disorder* ; Female ; Humans ; Psychology ; Vision, Low ; Visual Acuity

We report an anesthetic experience in a clinically euthyroid patient with hyperthyroxinemia (elevated free thyroxine, fT4 and normal 3, 5, 3'-L-triiodothyronine, T3) and suspected impairment of conversion from T4 to T3. Despite marked hyperthyroxinemia, this patient's perioperative hemodynamic profile was suspected to be the result of hypothyroidism, in reference to the presence of T4 to T3 conversion disorder. We suspected that pretreatment with antithyroid medication before surgery, surgical stress and anesthesia may have contributed to the decreased T3 level after surgery. She was treated with liothyronine sodium (T3) after surgery which restored her hemodynamic profile to normal. Anesthesiologists may be aware of potential risk and caveats of inducing hypothyroidism in patients with euthyroid hyperthyroxinemia and T4 to T3 conversion impairment.
Anesthesia ; Conversion Disorder ; Hemodynamics ; Humans ; Hyperthyroxinemia* ; Hypothyroidism ; Sodium ; Thyroxine ; Triiodothyronine

It is reported the fact that there is high incidence of conversion hysteria in Korea compared with other country. Many authors has stressed the importence of the possibity of hysteria when the patient complained of visual disturbance, visual field change and ocular discomfortness without any organic change of the eye. Author presented a case of conversion hysteria, 13years old male with chief complain of sudden severe visual disturbance, concentric constriction of the periperal visual field change and pseudomyopIa. He had treated at other eye clinics with the diagnosis of pseudomyopia or optic neuritis without improvement of ocular abnormalities over a year. Every efforts such as corrective glasses, systemic administration of steroids were failed. Finally author consulted this patient with the impression of conversion hysteria to the psychiatry department. All of ocular abnormalities were completly recorvered after treatment at the psychiatry department.
Constriction ; Conversion Disorder ; Diagnosis ; Eyeglasses ; Glass ; Humans ; Hysteria ; Incidence ; Korea ; Male ; Optic Neuritis ; Steroids ; Visual Fields

A Meige's syndrome is a rare neurological syndrome characterized by blepharospam and oromandibular dystonia. Its pathophysiology is not clearly determined yet, but the hypothesis of dopaminergic and cholinergic hyperactivity is most widely accepted. Anticholinergic drugs, antidopaminergic drugs and botulism toxin injection are currently used for the treatment of Meige's syndrome. The Meige's syndrome could be misdiagnosed as a psychaitric disorder such as conversion disorder or anxiety disorder, because clinical features of the Meige's syndrome are very variable and affected by psychological factors. The authors experienced one case of a 49-year-old female patient who was initally misdiagnosed as conversion disorder but confirmed later as Meige's syndrome, and then successfully treated.
Anxiety Disorders ; Botulism ; Conversion Disorder* ; Diagnosis, Differential* ; Dystonia ; Female ; Humans ; Middle Aged ; Psychology

OBJECTIVES: This study was designed to compare the relationships of psychopathology, stress event frequency and stress perception between globus hystericus patients and normal subjects, and to assess coping strategy and susceptibility for assisting the understanding of psychological mechanism and future treatment modalities. METHODS: Thirty-two globus hystericus patients who were consulted from the department of otolaryngology and fifty-three healthy subjects participated in this study. The authors used SCL-90-R(Korean Symptom Check List-90-Revision) for the measurement of psychiatric symptoms, GARS(Global Assessment of Recent Stress Scale) for stress perception, Social Readjustment Rating Scale for stress frequency and the Weisman Coping Strategy Scale for coping ability and susceptibility. The SPSS version 10.0 for Windows was used for statistical analysis. RESULTS: 1) Comparison of demographic characteristics showed no significant difference except level of education, which was significantly lower in the patient group. 2) The score of depression and anxiety items in SCL-90-R were significantly higher in the patient group. 3) The score of all subclasses in the GARS scale was significantly higher in the patient group. 4) The scores of neutral life event frequency, negative life event frequency, and negative life events more than 1 year past in social Readijustment Rating Scale, were significantly higher in the patient group, but there was no significant difference in positive life event frequency. 5) Weisman Coping Strategy Scale showed suppression, compliance, redefinition, intellectualism and displacement to be higher in frequency in descending order. Projection and fatalism were lower in frequency. 6)The patient group was susceptible to frustration, anxiety & fear, depression in descending order. CONCLUSION: Globus hystericus patients showed higher stress frequency, stress perception, and used positive coping strategies. Globus hystericus has an intimate association with stress factors, so an appropriate management is required in view of treatment.
Anxiety ; Compliance ; Conversion Disorder* ; Depression ; Education ; Frustration ; Humans ; Otolaryngology ; Psychopathology ; Social Perception

OBJECTIVES: The author tried to find out reasons why and how hysteria(and conversion disorder) patient numbers, which were so prevalent even a few decades ago, have decreased and the phenotype of symptoms have changed. METHODS: The number of visiting patients diagnosed with conversion disorder and their phenotype of symptoms were investigated through chart reviews in a psychiatric department of a University hospital for the last 12 years. Additionally, the characteristics of conversion disorder patients visiting the emergency room for last 2 years were also reviewed. Those results were compared with previous research results even if it seemed to be an indirect comparisons. The research relied on Briquet P. and Charcot JM's established factors of the vicissitudes of hysteria(and conversion disorder) which has been the framework for more than one hundred and fifty years since hysteria has been investigated. RESULTS: The author found decreased numbers and changes of the phenotype of the hysteria patients(and conversion disorder) over the last several decades. The decreased numbers and changes of the symptoms of those seemed to be partly due to several issues. These issues include the development of the diagnostic techniques to identify organic causes of hysteria, repeated changes to the symptom descriptions and diagnostic classification, changes of the brain nervous functions in response to negative emotions, and the influence of human evolution. CONCLUSIONS: The author proposed that the evolutionary brain discord reaction theory explains the causes of disappearance of and changes to symptoms of hysteria(conversion disorder). Most patients with hysteria(conversion disorder) have been diagnosed in the neurological department. For providing more appropriate treatment and minimizing physical disabilities to those patients, psychiatrists should have a major role in cooperating not only with primary care physicians but with neurologists. The term 'hysteria' which had been used long ago should be revived and used as a term to describe diseases such as somatic symptom disorder, functional neurological symptoms, somatization, and somatoform disorders, all of which represent almost the same vague concept as hysteria.
Brain* ; Classification ; Conversion Disorder ; Emergency Service, Hospital ; Humans ; Hysteria ; Phenotype ; Physicians, Primary Care ; Psychiatry ; Somatoform Disorders

OBJECTIVE: Chronic neck or back pain can be managed with various procedures. Although these procedures are usually well-tolerated, a variety of side effects have been reported. In this study we reviewed cases of unexpected temporary adverse events after blocks and suggest possible causes. METHODS: We reviewed the records of patients treated with spinal pain blocks between December 2009 and January 2011. The types of blocks performed were medial branch blocks, interlaminar epidural blocks and transforaminal epidural blocks. During the first eight months of the study period (Group A), 2% mepivacaine HCL and triamcinolone was used, and during the last six months of the study period (Group B), mepivacaine was diluted to 1% with normal saline. RESULTS: There were 704 procedures in 613 patients. Ten patients had 12 transient neurologic events. Nine patients were in Group A and one was in Group B. Transient complications occurred in four patients after cervical block and in eight patients after lumbar block. Side effects of lumbar spine blocks were associated with the concentration of mepivacaine (p<0.05). The likely causes were a high concentration of mepivacaine in five patients, inadvertent vascular injection in three patients, intrathecal leak of local anesthetics in one, and underlying conversion disorder in one. CONCLUSION: Spinal pain blocks are a good option for relieving pain, but clinicians should always keep in mind the potential for development of inevitable complications. Careful history-taking, appropriate selection of the anesthetics, and using real-time fluoroscopy could help reduce the occurrence of adverse events.
Anesthetics ; Anesthetics, Local ; Back Pain ; Conversion Disorder ; Fluoroscopy ; Humans ; Mepivacaine ; Neck ; Paralysis ; Spine ; Triamcinolone