Psychosocial interventions for conversion disorder

 

Abstract

Background

Conversion disorder is an alteration or loss of physical functioning suggestive of a physical disorder that is thought to be due to a psychological stressor or conflict. The fact that many theories about the cause of conversion disorder focus on psychological and social factors would suggest that a psychosocial intervention might be of most benefit.

Objectives

To investigate the efficacy of psychosocial interventions on people diagnosed with conversion disorder compared with standard care, a biological intervention or another psychosocial intervention.

Search methods

We searched the Cochrane Depression, Anxiety and Neurosis Group Trials Register (May 2004), various databases on OVID (February 2004), handsearched reference lists and textbooks on conversion disorder and contacted relevant authors.

Selection criteria

We included all randomised controlled trials that compared psychosocial interventions for conversion disorder with standard care or other interventions (biological or psychosocial).

Data collection and analysis

We reliably selected, quality assessed and extracted data from the studies. For dichotomous outcomes we calculated a relative risk with its associated 95% confidence interval and a number needed to treat. For continuous data we calculated a weighted mean difference.

Main results

The search identified 260 references, 217 were clearly not relevant to this review and excluded on the basis of their titles and abstracts, 40 more were excluded after reading the full papers (the reasons are given in the excluded studies tables) and only three studies (total n =119) met the inclusion criteria. One study was concerned with paradoxical injunction therapy and the other two studied the value of hypnosis. The three studies had different interventions and control groups so the results could not be combined. All of the studies were of poor methodological quality and it is therefore difficult to place much value on the results of the studies. We were unable to include some data because of poor reporting.

Authors' conclusions

Randomised studies are possible in this field. The use of psychosocial interventions for conversion disorder requires more research and it is not possible to draw any conclusions about their potential benefits or harms from the included studies.

 

Plain language summary

Psychosocial interventions for conversion disorder

Conversion disorder is an alteration or loss of physical functioning suggestive of a physical disorder that is thought to be due to a psychological stressor or conflict. Psychosocial interventions are thought to be helpful for people with conversion disorder. We conducted a review of all relevant randomised trials of psychosocial interventions, but were only able to include three small studies. There were no conclusive results and at present, the benefits or harms of psychosocial interventions for conversion disorder are unclear.

 

摘要

背景

轉化症的心理社會治療

轉化症是身體出現類似生理疾病的功能變化或喪失，起因被認為是心理的壓力或衝突。許多關於轉化症成因的理論聚焦在心理與社會因素，暗示心理社會的治療可能會有最佳的效果。

目標

評估與標準照護、生理取向的治療或其他心理社會治療相比，對轉化症患者進行心理社會治療的有效性。

搜尋策略

我們搜尋the Cochrane Depression, Anxiety and Neurosis Group Trials Register (至2004年5月), 許多OVID的資料庫 (至2004年2月), 以及手動搜尋轉化症的文獻與教科書清單，並聯絡相關的作者。

選擇標準

我們納入所有的隨機控制試驗，比較對轉化症進行心理社會治療，與進行標準照護或其他治療(生理的或心理社會的)。

資料收集與分析

我們一致地選擇，質性地評估，並從研究中擷取資料。對於二分的結果變項我們計算相對風險以及其95%信賴區間、益一需治數。對於連續變項我們計算加權的平均值差異。

主要結論

搜尋找到260篇文獻，其中217篇明顯與此篇回顧無關，以其篇名與摘要為基礎將其排除，另外40篇則在閱讀完整篇文獻後排除(原因列於排除研究的表格中)。最後只有3篇研究(總共119個參與者)符合納入的標準。一個研究是關於矛盾勸告治療，另外兩個研究是探討催眠的價值。此三篇研究使用不同的治療方式與對照組，因此結果無法加以合併。所有的研究在方法學上的品質都不佳，因此研究結果價值不高。因為報告不足，我們無法納入一些資料。

作者結論

在這個領域中，隨機的研究是可能的。對轉化症患者進行心理社會治療需要更多的研究。不可能從這次納入的研究中得到任何關於心理社會治療的潛在成效或傷害的結論。

翻譯人

本摘要由彰化基督教醫院陳美雀翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

轉化症是身體出現類似生理疾病的功能變化或喪失，起因被認為是心理的壓力或衝突。心理社會治療被認為是對轉化症患者有幫助的。我們對所有心理社會治療相關的隨機試驗進行回顧，但只能納入三篇小的研究。目前並沒有結論，對轉化症進行心理社會治療的效果或傷害仍是不清楚的。