Psychosocial interventions for conversion and dissociative disorders in adults

Area of Science:

• Psychiatry
• Neurology
• Psychology

Background:

• Conversion and dissociative disorders involve neurological symptoms unexplained by medical conditions, often linked to psychological stressors.
• These disorders manifest as real symptoms causing significant distress and functional impairment.

Purpose of the Study:

• To evaluate the efficacy and safety of psychosocial interventions for conversion and dissociative disorders in adults.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
• Searches included multiple databases up to August 2019, with inclusion criteria for RCTs comparing psychosocial interventions to control groups.
• Evidence certainty was assessed using the GRADE system, with downgrading for risk of bias, imprecision, and inconsistency.

Main Results:

• Seventeen RCTs with 894 participants were included, with evidence quality generally rated as very low to low.
• Few interventions showed statistically significant effects; for example, outpatient hypnosis showed potential benefit for impairment, and behavioral therapy for seizure reduction.
• No studies reported on adverse effects, and effects on functioning and quality of life ranged from small to none.

Conclusions:

• There is a significant lack of high-quality evidence regarding the effectiveness of psychosocial interventions for conversion and dissociative disorders in adults.
• Current evidence is insufficient to draw conclusions on the benefits or harms of these interventions.