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Ten-year prognosis of conversion disorder

C J Mace¹, M R Trimble

¹Department of Psychology, University of Warwick, Coventry.

The British Journal of Psychiatry : the Journal of Mental Science

|September 1, 1996

Summary

Patients with conversion disorder often experience chronic symptoms, with few later diagnosed with neurological disease. Somatisation disorder may develop if underlying conditions remain undiagnosed after hospital visits.

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Area of Science:

Neurology
Psychiatry
Healthcare Services Research

Background:

Conversion disorder is often associated with subsequent neurological disease, but predisposing factors and service utilization remain unclear.
Previous research has overlooked the long-term healthcare service use patterns of patients initially diagnosed with conversion disorder.

Purpose of the Study:

To compare the long-term clinical outcomes of patients investigated for pseudoneurological symptoms.
To assess the subsequent diagnostic trajectories and healthcare service utilization in patients with conversion disorder.

Main Methods:

A cohort of 73 patients initially evaluated for pseudoneurological symptoms at a neurology hospital was studied.
Clinical outcomes were compared to initial presentations, with 56 patients completing a structured interview on service use over 10 years.

Main Results:

Thirty patients reported no symptom relief at follow-up, often presenting with older age, chronic symptoms, and distinct psychiatric comorbidities.
A neurological diagnosis was confirmed in 11 patients, disproportionately represented among those with initially suspected neurological conditions.
Patients with poor outcomes utilized hospital and community services most frequently; high service users met somatisation disorder criteria at follow-up.

Conclusions:

The long-term prognosis for chronic conversion disorder symptoms remains poor, with subsequent neurological rediagnosis being less common than presumed.
Development of somatisation disorder is a potential outcome for patients who do not receive a definitive diagnosis of another condition during hospital care.

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