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Psychogenic movement disorders

Stephen G Reich1

  • 1Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.

Seminars in Neurology
|June 23, 2006
PubMed

Insights

Psychogenic movement disorders (PMDs) mimic organic conditions like tremor and dystonia, affecting 3% of specialty clinic patients. Diagnosis requires identifying incongruent features, with psychiatric intervention offering a path to successful management.

Area of Science:

  • Neurology
  • Psychiatry
  • Movement Disorders

Background:

  • Psychogenic movement disorders (PMDs) can mimic a wide spectrum of organic movement disorders, including tremor, dystonia, and myoclonus.
  • Approximately 3% of patients presenting to specialty movement disorder clinics are diagnosed with a PMD.

Observation:

  • Diagnosing PMDs involves not only excluding organic etiologies but also recognizing historical and examination findings incongruent with organic movement disorders.
  • Commonly, PMDs manifest as conversion disorders, often within the context of somatoform disorders; factitious disorder and malingering are less frequent.
  • Comorbid psychiatric conditions, such as depression, anxiety, and personality disorders, are highly prevalent in individuals with PMDs.

Findings:

  • Many PMDs present with chronic symptomology.
  • A multidisciplinary treatment approach, with a focus on psychiatric intervention, demonstrates potential for successful management.
  • Favorable prognostic indicators include a shorter symptom duration and the presence of a treatable comorbid psychiatric disorder.

Implications:

  • The prognosis for PMDs is poorer when factors such as compensation or pending litigation are present.
  • Understanding the diagnostic nuances and prognostic factors is crucial for effective patient care and management strategies in movement disorder clinics.

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