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Psychogenic disorders in neurology: frequency and clinical spectrum
Author(s) -
Lempert T.,
Dieterich M.,
Huppert D.,
Brandt T.
Publication year - 1990
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1990.tb03312.x
Subject(s) - psychogenic disease , neurology , medicine , pediatrics , conversion disorder , depression (economics) , neurological disorder , disease , psychiatry , central nervous system disease , surgery , economics , macroeconomics
Among 4470 consecutive neurological impatients presenting “with typical neurological symptoms” 405 (9%) were found to have psychogenic rather than neurological dysfunction of the nervous system as the primary cause of admission. This probably represents a conservative figure, since secondary and minor pseudoneurological symptoms were not included. Retrospective analysis of these cases showed that pain was the most common psychogenic symptom, followed by motor symptoms (in particular stance and gait disturbances), dizziness, psychogenic seizures, sensory symptoms, and visual dysfunction. Unilateral motor and sensory symptoms were equally distributed to the left and right side of the body. Psychiatric abnormalities in these patients were heterogenous. Depressive syndromes were most common (38%), whereas hysterical features were less frequent than expected (9%). On discharge, improvement was significantly better for patients with recent onset of symptoms (2 weeks or less) than for those with longstanding disturbances. Short‐term outcome was best for motor symptoms and worst for pain. Improvement was independent of psychiatric findings, coexistence of a neurological disease, age, and sex.