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Research paper
Specialist inpatient treatment for severe motor conversion disorder: a retrospective comparative study
  1. Ruaidhri McCormack1,2,
  2. John Moriarty3,
  3. John D Mellers3,
  4. Paul Shotbolt3,
  5. Rosa Pastena3,
  6. Nadine Landes3,
  7. Laura Goldstein4,
  8. Simon Fleminger5,
  9. Anthony S David2
  1. 1National Institute for Health Research (NIHR) Biomedical Research Centre, South London & Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, UK
  2. 2Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King's College London, London, UK
  3. 3South London & Maudsley NHS Foundation Trust, London, UK
  4. 4Department of Psychology and NIHR Dementia Biomedical Research Unit at South London & Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, UK
  5. 5South London & Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, UK
  1. Correspondence to Dr Ruaidhri McCormack, Section of Cognitive Neuropsychiatry, Institute of Psychiatry, 16 De Crespigny Park, London SE5 8AF, UK; r.mccormack{at}kcl.ac.uk

Abstract

Background Gold standard protocols have yet to be established for the treatment of motor conversion disorder (MCD). There is limited evidence to support inpatient, multidisciplinary intervention in chronic, severe cases.

Aims To evaluate the characteristics and outcomes of MCD patients admitted to a specialist neuropsychiatric inpatient unit.

Methods All patients admitted to the Lishman Unit (years 2007–2011) with a diagnosis of MCD were included. Data relevant to characteristics and status with regard to mobility, activities of daily living (ADLs) and Modified Rankin Scale (MRS) score at admission and discharge were extracted.

Results Thirty-three cases (78.8% female) were included; the median duration of illness was 48 months. In comparison with brain injury patients admitted to the same unit, more cases had histories of childhood sexual abuse (36.4%, n=12), premorbid non-dissociative mental illness (81.1%, n=27) and employment as a healthcare/social-care worker (45.5%, n=15). Cases showed significant improvements in MRS scores (p<0.001), mobility (p<0.001) and ADL (p=0.002) following inpatient treatment.

Conclusions Patients with severe, long-standing MCD can achieve significant improvements in functioning after admission to a neuropsychiatry unit.

  • NEUROPSYCHIATRY
  • MOVEMENT DISORDERS
  • REHABILITATION

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