This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Related articles in BJP
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by SHAPIRO, A. P.
Right arrow Articles by TEASELL, R. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by SHAPIRO, A. P.
Right arrow Articles by TEASELL, R. W.
The British Journal of Psychiatry (2004) 185: 140-146
© 2004 The Royal College of Psychiatrists

Behavioural interventions in the rehabilitation of acute v. chronic non-organic (conversion/factitious) motor disorders

ALLAN P. SHAPIRO, PhD

University of Western Ontario and St Joseph's Health Care, London, Canada

ROBERT W. TEASELL, MD

University of Western Ontario, St Joseph's Health Care and Parkwood Hospital, London, Canada

Correspondence: Allan P. Shapiro, Rheumatology Institute,K-370, St Joseph's Health Care, 268 Grosvenor St, London, Ontario N6A 4V2, Canada. E-mail: allan.shapiro{at}sjhc.london.on.ca

Declaration of interest None.

Background Repeated case series have documented the effectiveness of multidisciplinary in-patient behavioural treatment for conversion disorders. However, in the absence of controlled research, treatment success could be attributed to providing patients with a face-saving opportunity to get better.

Aims The present study contrasts two behavioural treatments to elucidate the factors underlying successful in-patient rehabilitation of this population.

Method Thirty-nine patients underwent a standard behavioural programme. Using a crossover design, patients who did not improve underwent a strategic-behavioural treatment in which they and their families were told that full recovery constituted proof of an organic aetiology whereas failure to recover was definitive proof of a psychiatric aetiology.

Results Chart review indicated that the standard behavioural treatment was effective for 8/9 ‘acute’ patients but only for 1/28 ‘chronic’ patients. Of the 21 patients with chronic motor disorder who then under went the strategic-behavioural intervention, 13 were symptom-free at discharge.

Conclusions The strategic intervention was superior to standard behavioural treatment for patients with chronic motor disorder. Treatment components previously deemed critical for the effectiveness of behavioural treatment may be unnecessary.


Related articles in BJP:

PETER TYRER
BJP 2004 185: 188. [Full Text]  



This article has been cited by other articles:


Home page
 JWatch Women's HealthHome page
Successful Treatment of "Hysteria"
Journal Watch Women's Health, October 19, 2004; 2004(1019): 9 - 9.
[Full Text]