Article Text
Abstract
Background Conversion disorder is largely managed by neurologists, for whom it presents great challenges to understanding and management. This study aimed to quantify these challenges, examining how neurologists understand conversion disorder, and what they tell their patients.
Methods A postal survey of all consultant neurologists in the UK registered with the Association of British Neurologists.
Results 349 of 591 practising consultant neurologists completed the survey. They saw conversion disorder commonly. While they endorsed psychological models for conversion, they diagnosed it according to features of the clinical presentation, most importantly inconsistency and abnormal illness behaviour. Most of the respondents saw feigning as entangled with conversion disorder, with a minority seeing one as a variant of the other. They were quite willing to discuss psychological factors as long as the patient was receptive but were generally unwilling to discuss feigning even though they saw it as their responsibility. Those who favoured models in terms of feigning were older, while younger, female neurologists preferred psychological models, believed conversion would one day be understood neurologically and found communicating with their conversion patients easier than it had been in the past.
Discussion Neurologists accept psychological models for conversion disorder but do not employ them in their diagnosis; they do not see conversion as clearly different from feigning. This may be changing as younger, female neurologists endorse psychological views more clearly and find it easier to discuss with their patients.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
Statistics from Altmetric.com
Supplementary materials
Web Only Data
Files in this Data Supplement:
Footnotes
Funding RAK was supported by a Biomedical Ethics Fellowship from the Wellcome Trust (grant No 079743). SCW was partially funded by the South London and Maudsley NHS Foundation Trust/Institute of Psychiatry NIHR (National Institute of Health Research) Biomedical Research Centre.
Competing interests None.
Ethics approval This study was conducted with the approval of King's College Research Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.