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Conversion disorder: "an adverse reaction" to watch out for
Pearl Sherienne C Legaspi1, Maria Luisa Abad Venida
1Department of Dermatology, Jose R. Reyes Memorial Medical Center, Rizal Avenue, Sta. Cruz, Manila, Philippines. ticklemeps03@yahoo.com
Dermatologic Clinics
|March 19, 2008
Summary
A patient in a leprosy drug trial experienced physical symptoms, later diagnosed as conversion disorder. This highlights the importance of considering psychological factors in clinical trial adverse events.
Area of Science:
- Clinical Medicine
- Psychiatry
- Infectious Diseases
Background:
- Leprosy treatment historically involves multidrug therapy (MDT).
- Clinical trials are crucial for evaluating new therapeutic regimens.
- Adverse events in trials require thorough investigation.
Purpose of the Study:
- To report a case of conversion disorder in a leprosy clinical trial participant.
- To emphasize the differential diagnosis of physical symptoms in research settings.
Main Methods:
- A single subject participated in a World Health Organization (WHO) multicenter, double-blinded trial.
- The subject received either ofloxacin-containing MDT or placebo (WHO/MDT-MB regimen).
- Symptoms were assessed, and diagnostic workups were performed; unblinding revealed the treatment arm.
Main Results:
- The subject developed physical symptoms hours after starting the regimen.
- Medical evaluations could not establish a physical diagnosis.
- The subject was diagnosed with conversion disorder and treated with an antipsychotic.
Conclusions:
- Conversion disorder can manifest as physical symptoms in clinical trial participants.
- Psychological factors should be considered in unexplained adverse events during drug trials.
- Careful case management is essential for participants experiencing psychosomatic symptoms.
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