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dc.contributor.authorNicholson, TR-
dc.contributor.authorAybek, S-
dc.contributor.authorCraig, T-
dc.contributor.authorHarris, T-
dc.contributor.authorWojcik, W-
dc.contributor.authorDavid, AS-
dc.contributor.authorKanaan, Richard A A-
dc.identifier.citationPsychological Medicine 2016; 46(12): 2617-2626en_US
dc.description.abstractPsychological models of conversion disorder (CD) traditionally assume that psychosocial stressors are identifiable around symptom onset. In the face of limited supportive evidence such models are being challenged. Forty-three motor CD patients, 28 depression patients and 28 healthy controls were assessed using the Life Events and Difficulties Schedule in the year before symptom onset. A novel ‘escape’ rating for events was developed to test the Freudian theory that physical symptoms of CD could provide escape from stressors, a form of ‘secondary gain’. CD patients had significantly more severe life events and ‘escape’ events than controls. In the month before symptom onset at least one severe event was identified in 56% of CD patients – significantly more than 21% of depression patients [odds ratio (OR) 4.63, 95% confidence interval (CI) 1.56–13.70] and healthy controls (OR 5.81, 95% CI 1.86–18.2). In the same time period 53% of CD patients had at least one ‘high escape’ event – again significantly higher than 14% in depression patients (OR 6.90, 95% CI 2.05–23.6) and 0% in healthy controls. Previous sexual abuse was more commonly reported in CD than controls, and in one third of female patients was contextually relevant to life events at symptom onset. The majority (88%) of life events of potential aetiological relevance were not identified by routine clinical assessments. Nine per cent of CD patients had no identifiable severe life events. Evidence was found supporting the psychological model of CD, the Freudian notion of escape and the potential aetiological relevance of childhood traumas in some patients. Uncovering stressors of potential aetiological relevance requires thorough psychosocial evaluation.en_US
dc.subjectConversion disorderen_US
dc.subjectFunctional neurological disorderen_US
dc.subjectLife eventsen_US
dc.titleLife events and escape in conversion disorderen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitlePsychological Medicineen_US
dc.identifier.affiliationAustin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationSection of Cognitive Neuropsychiatry, Institute of Psychiatry Psychology & Neuroscience, King's College, London, UKen_US
dc.identifier.affiliationLaboratory for Behavioral Neurology and Imaging of Cognition, Fundamental Neurosciences Department, Geneva University, Geneva, Switzerlanden_US
dc.identifier.affiliationHealth Services Research Department, Institute of Psychiatry Psychology & Neuroscience, King's College, London, UKen_US
dc.identifier.affiliationDepartment of Psychological Medicine, Institute of Psychiatry Psychology & Neuroscience, King's College, London, UKen_US
dc.identifier.affiliationDepartment of Psychiatry, the University of Melbourne, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.type.austinJournal Articleen_US
item.openairetypeJournal Article-
item.fulltextNo Fulltext- (University of Melbourne)-
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