Ten-year prognosis of conversion disorder

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.