Trastorno conversivo en niños y adolescentes
Duque, Paula Andrea
Revista Colombiana de Psiquiatría, 0034-7450, Vol. 44, Nro. 4, 2015, p. 237-242
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Background Conversion disorder is diagnosed late, by exclusion and with a high risk of complications. There is a wide experience in adults that is not extrapolated to paediatric patients. According to the literature, the prognosis is better in children, but this changes when other variables such are included, such as comorbidities, late diagnosis and a very convincing social image of the neurological disease. Objective To review the medical literature on the clinical features, diagnosis, comorbidities and treatment of this disorder. Methods A literature research was performed on Medline and Pubmed, the terms used were “conversion disorder”, pseudoseizures, treatment, clinic, children (“conversion disorder” OR hysteria OR hysterical) (child OR children OR childhood OR pediatric OR paediatric). The most relevant material found is included in this review. Conclusions Conversion disorder is often an imprecise diagnosis in high complexity paediatric services. No consensus was found in the literature search on how to treat patients after the initial diagnosis. The evidence that it becomes chronic is not strong enough, just as the evidence is not convincing enough to argue that comorbidity factors are those maintained over time. Clearly, there is no medical experience of the natural history of this disorder in children and adolescents. It is only known is that it is a complex condition, on which there is experience only in the diagnosis and treatment of the acute state, but not so in the long-term care. It is proposed that each patient is studied in detail in order to define the psychiatric diagnosis and its treatment.
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