Childhood sexual abuse predicts treatment outcome in conversion disorder/functional neurological disorder, 2020, Van der Feltz-Cornelis et al

Andy · Feb 9, 2020

Another example of conversion disorder=FND.

Objective

Explore trauma, stress, and other predictive factors for treatment outcome in conversion disorder/functional neurological disorder (CD/FND).

Methods
Prospective observational design. Clinical cohort study among consecutive outpatients with DSM‐IV CD/FND in a specialized mental health institution for somatic symptom disorders and related disorders (SSRD), presented between 1 February 2010 and 31 December 2017. Patient files were assessed for early childhood trauma, childhood sexual abuse, current stress, and other predictive factors. Patient‐related routine outcome monitoring (PROM) data were evaluated for treatment outcome at physical (Patient Health Questionnaire [PHQ15], Physical Symptoms Questionnaire [PSQ]) level as primary outcome, and depression (Patient Health Questionnaire [PHQ9]), anxiety (General Anxiety Disorder [GAD7]), general functioning (Short Form 36 Health Survey [SF36]), and pain (Brief Pain Inventory [BPI]) as secondary outcome.

Results
A total of 64 outpatients were included in the study. 70.3% of the sample reported childhood trauma and 64.1% a recent life event. Mean scores of patients proceeding to treatment improved. Sexual abuse in childhood (F(1, 28) = 30.068, β = 0.608 p < .001) was significantly associated with worse physical (PHQ15, PSQ) treatment outcome. 42.2% reported comorbid depression, and this was significantly associated with worse concomitant depressive (PHQ9) (F[1, 39] = 11.526, β = 0.478, p = .002) and anxiety (GAD7) (F[1,34] = 7.950, β = 0.435, p = .008) outcome.

Conclusion
Childhood sexual abuse is significantly associated with poor treatment outcome in CD/FND. Randomized clinical trials evaluating treatment models addressing childhood sexual abuse in CD are needed.
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Open access, https://onlinelibrary.wiley.com/doi/full/10.1002/brb3.1558

chrisb · Feb 9, 2020

I do not propose to read the full paper, but would one not need, separately, to assess the severity of the alleged abuse and see whether there is any correlation between that and severity of symptoms of conversion disorder. The term "sexual abuse" seems likely to cover a very broad spectrum.

TiredSam · Feb 9, 2020

BPS abuse predicts treatment outcome. The perpetrators are manipulative, predatory, groom their victims and like to establish themselves in high status public positions so they can carry on their abuse in broad daylight. #M.E. too.

Mithriel · Feb 11, 2020

chrisb said: ↑

I do not propose to read the full paper, but would one not need, separately, to assess the severity of the alleged abuse and see whether there is any correlation between that and severity of symptoms of conversion disorder. The term "sexual abuse" seems likely to cover a very broad spectrum.
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Yes, indeed. The phrase is used without being defined in most cases and the spectrum is very wide. The consequences of the abuse are very diverse as well. They are taking something that is incredibly complex and making it a box ticking exercise to give a number they then use to explain incredibly complex medical and biological issue.

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Childhood sexual abuse predicts treatment outcome in conversion disorder/functional neurological disorder, 2020, Van der Feltz-Cornelis et al

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Childhood sexual abuse predicts treatment outcome in conversion disorder/functional neurological disorder, 2020, Van der Feltz-Cornelis et al

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Mithriel Senior Member (Voting Rights)

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