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[Hysterical mutism].

J-P Schuster1, S Mouchabac, Y Le Strat

  • 1Service universitaire de psychiatrie, hôpital Corentin-Celton, assistance publique-hôpitaux de Paris, université Paris Descartes, France. jean-pierre.schuster@ccl.aphp.fr

L'Encephale
|October 29, 2011
PubMed
Summary
This summary is machine-generated.

Hysterical mutism, a rare conversion disorder, presents as voice loss without physical vocal cord damage. Despite its history, it remains poorly understood and difficult to diagnose, necessitating further research for improved patient care.

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Area of Science:

  • Neurology
  • Psychiatry
  • Otolaryngology

Background:

  • Hysterical mutism is a conversion disorder characterized by voice loss without physical vocal cord pathology.
  • Historically identified, it remains poorly understood and difficult to diagnose, with limited treatment guidelines.
  • It was first described in the medical field by the Salpêtrière School in the late 19th century.

Purpose of the Study:

  • To systematically review the literature on hysterical mutism.
  • To assess the current understanding of its epidemiology, diagnosis, and treatment.
  • To highlight the need for renewed interest and research into this condition.

Main Methods:

  • A systematic literature review was conducted using Medline, SUDOC, and BIUM.
  • Search terms included mutism, functional aphonia, conversion disorder, and hysteria.
  • Analysis focused on epidemiological data, diagnostic challenges, and clinical characteristics.

Main Results:

  • Hysterical mutism is rare, estimated at 5% of functional dysphonia cases, predominantly affecting women aged 30-40.
  • Onset is typically sudden, often following a stressful event, with rapid remission (within 3 months) but frequent recurrence.
  • Diagnostic criteria lack consensus, and psychiatric comorbidity is not consistently observed; its natural history remains unknown.

Conclusions:

  • Hysterical mutism is classified under conversion disorders in the DSM-IV-TR, not as a distinct entity in international classifications.
  • Stigma associated with the condition hinders medicalization and patient support.
  • Further research is crucial to better understand hysterical mutism and enhance patient care.