BRAIN and NERVE Shinkei Kenkyu no Shinpo Volume 70, Issue 9 (September 2018)

Assessments and Treatments for Neurological Symptoms That Do Not Match Organic Findings Takaaki Yasuda 1 , Junichi Hatakeda 1,2 , Haruo Yoshimasu 1 1Department of Psychiatry, Saitama Medical Center, Saitama Medical University 2Higashimatsuyama Hospital Keyword: 変換症 , 機能性神経症状症 , 身体症状症 , 身体表現性障害 , 心因性疾患 , 心身症 , conversion disorder , functional neurological symptom disorder , somatic symptom disorder , somatoform disorder , psychogenic disease , psychosomatic disease pp.971-979
Published Date 2018/9/1
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Many clinicians treat patients with neurological symptoms such as muscle weakness and involuntary movements, that do not correspond to organic findings. The differential diagnosis of patients with medically unexplainable symptoms includes conversion disorder, somatic symptom disorder, and illness anxiety disorder among others. Conversion disorder is a mental disorder with pseudo-neurological symptoms that are not due to an organic abnormality. For its diagnosis it is necessary to show that the symptoms and findings are not compatible with neurological diseases. Conversion disorder and any neurological diseases can coexist, in which cases neurologists and psychiatrists should cooperate when treating the patient. However, it is difficult to clearly distinguish individual symptoms by their mechanism.

Patients complaining of physical symptoms, including those with conversion disorder, require careful explanation that takes into account the patient's explanatory model. Clinicians must switch from an acute disease model to a chronic disease model. These patients are more likely to concentrate consciously on their physical condition and clinicians should help patients avoid ruminating on their physical symptoms. Because it is not simple to completely exclude physical disorders and prove that the symptoms are psychogenic, confirming a diagnosis should be performed carefully.

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BRAIN and NERVE-神経研究の進歩
70巻9号 (2018年9月)
電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院