PubMed · 6854863
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L D Young, H H Harsch. 1983-06-24. Factitious illness v conversion disorder.. https://pubmed.ncbi.nlm.nih.gov/6854863/
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Psychogenic nonepileptic seizures (NES) are commonly encountered in clinical practice, and they may pose difficult diagnostic problems. For appropriate evaluation and treatment of NES, a multidisciplinary team approach is needed; typically, a neurologist with expertise in epilepsy, a psychologist or psychiatrist, and a support staff should be involved. Psychogenic NES have no single initial clinical manifestation, and various etiologic factors may contribute to their development. Of importance, psychogenic NES are "real" seizures that may be as disabling as epileptic seizures. Most often, they occur on a subconscious level, and the patient may have no control over their occurrence. Precipitation or termination of a habitual seizure during video-electroencephalographic monitoring has often been used to distinguish NES from epileptic seizures, but the results can sometimes be misleading. Numerous additional diagnostic techniques can be used to assist in making the diagnosis. Treatment is based on the type of psychiatric disorder present. Favorable prognostic factors include being female and having an independent lifestyle, normal electroencephalographic findings, higher intelligence, and no prior psychotherapy.
Modern theories on hysteria are presented by describing the historical context of various scientific approach to hysterical phenomena as well as the concepts of dissociation and conversion which are closely linked. The subdivision of the classical hysterical neurosis into the dissociative disorders and the somatoform disorders within the diagnostic classifications of ICD-10 and DSM-III-R respectively DSM-IV is illustrated and discussed. These new theories have prompted the development of some instruments such as diagnostic interviews (SCID-D) and self-measuring questionnaires (DES). The scientific value and importance of these instruments is discussed, especially with regard to further studies on dissociative disorders, particularly in the German-speaking countries.