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The relationship between psychosocial trauma type and conversion (functional neurological) disorder symptoms: a cross-sectional study, 2021, Morsy

Discussion in 'Health News and Research unrelated to ME/CFS' started by Andy, Apr 27, 2021.

  1. Andy

    Andy Committee Member (& Outreach when energy allows)

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    Abstract

    Objective:

    Psychosocial trauma was associated with developing conversion disorder (also known as functional neurological disorder) before Freud, though why a particular symptom should arise is unknown. We aimed to determine if there was a relationship between trauma type and symptom.

    Methods:
    We retrospectively reviewed the medical records of patients attending Australia’s first functional neurology clinic, including referral, clinic letters and a clinic questionnaire.

    Results:
    There were 106 females, 43 males and five transgender patients. Sensory (51%), motor (47%) and seizures (39%) were the commonest functional symptoms. Most patients (92%) reported stressors associated with symptom onset. Multiple trauma/symptom type associations were found: patients with in-law problems experienced more cognitive symptoms (p = .036), for example, while expressive speech problems more commonly followed relationship difficulties (p = .021).

    Conclusion:
    Associations were found between type of traumatic events and type of symptoms in conversion disorder. This will require verification in a larger sample.

    Paywall, https://journals.sagepub.com/doi/10.1177/10398562211009247
     
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  2. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    I wonder if the authors investigated trauma which arises from being diagnosed with conversion disorder/functional disorder and having none of your symptoms actually investigated.
     
  3. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    Until they develop a model that predicts in advance who will subsequently develop which symptoms, these results mean nothing.
     
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  4. Sean

    Sean Senior Member (Voting Rights)

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    Even then it does not necessarily tell us why they develop them.

    The early signs of many diseases are vague & generic, and can include what are conventionally classified as psych symptoms.

    The question is what is the direction of causation?
     
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  5. alex3619

    alex3619 Senior Member (Voting Rights)

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    Predictive models based on association can easily be just association. Causality not required. What it does hint at, requiring more study, is there might be an underlying causative factor. Like sugar with obesity and tooth decay. If all you had was an association between obesity and tooth decay, you would not want to predict that either causes the other.

    PS
    What I am saying is that either direction can be wrong, it could be some other factor driving both things. So yes, the direction of causation is critical.
     
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  6. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    If you could demonstrate, all other things being equal, that 75% of children bitten by a dog later go on to develop IBS but never develop non epileptic seizures and 65% kicked by a horse go on the develop non epileptic seizures but never IBS then I would consider there is a strong argument for causation, as I am not sure how IBS could directly cause a prior dog bite but not previously being kicked by a horse or that an underlying risk for later non epileptic seizures leaves you less vulnerable to earlier dog bites but more vulnerable to having been previously kicked by a horse.

    [added - though obviously you would have to consider whether the later IBS group did not have differentially higher levels of earlier dog contact and the later seizure group did not have differentially higher earlier levels of horse contact, ie prove that all other things were equal.]

    However given we will most likely never see anything as specific or clear cut as that, and that the most likely outcome of any prospective study is no specific association of a particular type of trauma with a specific later symptom presumed to be a functional neurological disorder reflecting an underlying conversion disorder, this is all pure fantasy.

    [struggling with brain fog so several times corrected wording to actually make sense]
     
    Last edited: Apr 28, 2021
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  7. Milo

    Milo Senior Member (Voting Rights)

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    I guess those of us without in-laws are in the clear :rolleyes:
     
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  8. Hutan

    Hutan Moderator Staff Member

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    :eek: what do we know about this? A couple of the researchers have links with Austin Health, Heidelberg, Melbourne. Oldmeadow, is a BPS leaning doctor with links to Austin Health.
    An unusual mix of authors from Melbourne (Australia) and Egypt.

    @Joan Crawford - I'm thinking that you will have many opportunities to copy, paste and send your letter about another study on previous trauma, should you feel inclined.

    Indeed. It is about as scientific as phrenology.
    It's just so bizarre.

    I'm looking forward to a free access link.
     
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  9. NelliePledge

    NelliePledge Moderator Staff Member

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    What next, problems with your neighbours associated with cognitive symptoms....
     
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  10. Tia

    Tia Senior Member (Voting Rights)

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    Eh? This is just weird. Who knows, there may be an association between types of trauma and some kinds of health problems (maybe) but I'm 100% sure it doesn't work like this. What next, problems with your mum's best friend causes x whilst problems with great aunt's boyfriend causes y?

    Also, are we calling a difficult relationship with in-laws 'trauma' now? The word 'trauma' is going to become completely meaningless if every normal minor life difficulty is said to cause trauma.
     
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  11. Joan Crawford

    Joan Crawford Senior Member (Voting Rights)

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    Oh I think I might just do that

    V pleased to have FM and trauma debunked paper accepted in psychological medicine. This whole area of 'psychobabble' needs the wind taking out of its sails.

    Believe it or not but psychologists can't actually just make shit up and it's OK!!! No it ain't. There has to be a plausible mechanism - psychological or physical to explain stuff. Landing from Mars 'cos that's flavour of the month or wotnot is muppetry and it is not what the majority of professional psychologists do. Honest
     
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  12. Joan Crawford

    Joan Crawford Senior Member (Voting Rights)

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    Wtf? Words fail
     
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  13. Joan Crawford

    Joan Crawford Senior Member (Voting Rights)

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    Perhaps the journal should be renamed Upside down Psychiatry
     
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  14. rvallee

    rvallee Senior Member (Voting Rights)

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    Appears so. At least some do. Maybe this is a joke but frankly it's not any more absurd than the standard BPS stuff.

     
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  15. Art Vandelay

    Art Vandelay Senior Member (Voting Rights)

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    The name 'Kanaan' looked familiar. It turns out he's an old crony of Wessely, Sharpe, and Stone. His publication history is full of quackery and pseudoscience and he has been influential in promoting the nonsense of 'secondary benefits'.

    Unfortunately for Australians, he appears to have moved here.

    In true BPS fashion, he also has managed to keep his snout firmly planted in a trough of taxpayer's money. He scored a grant not long ago to develop a 'treatment' for Australians with suspected tick-borne illness. Unsurprisingly, the treatment is.... you guessed it... CBT.

    Patients with tick-borne diseases here are furious that, after years of lobbying to get decent research funded in this area, this rent-seeking quack ended up with much of it.

    This post has been copied and following discussion moved to this thread: Tick-borne diseases in Australia

     
    Last edited by a moderator: Apr 30, 2021
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  16. Mithriel

    Mithriel Senior Member (Voting Rights)

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    I tried to explain this paper to my husband and he summed it up succinctly. "Your mother in law does your head in but your partner makes you shut up"
     
  17. Woolie

    Woolie Senior Member

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    Look at the p values! Not statistically significant if you correct for the number of chances they gave themselves to get a result.
     
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  18. Woolie

    Woolie Senior Member

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    This is a really good point. I saw a study a few years back on Alzheimers disease - it found that the rate of diagnosis of depressive disorder was well above chance in AD patients in the two years immediately preceding their AD diagnosis.

    Nobody is trying to say depression causes AD. That would be stupid. But the psych symptoms are one of the earliest markers that something is not right.
     
    Last edited: Apr 30, 2021
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  19. Sean

    Sean Senior Member (Voting Rights)

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    They did reach their minimum target: Sufficient justification for ongoing employment.

    This will require verification in a larger sample.

    Several times, no doubt.
     
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  20. Trish

    Trish Moderator Staff Member

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