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Psychosocial aspects of acquired hearing impairment in the patients with otosclerosis.

UNLABELLED: Currently available evidence reveals comparatively few studies of the psychological and social effects of acquired hearing impairment, in spite of the fact that clinicians have for a long time been aware of a connection between acquired hearing impairment and mental disorders. The existing data indicate that psychological disorders are significantly more frequent in a population with hearing impairment than in the average population and are accompanied by disharmony in interpersonal and social relations. AIM: Establishing the presence and the type of mental disorders in patients with hearing impairment due to otosclerosis, before and 6 months after corrective surgery, as well as finding the role of adaptation style (personal adjustment) and facing strategy (communication strategies) as mediating variables between the acquired hearing impairment and observed psychical changes. METHODOLOGY: in 60 subjects, potential candidates for stapedectomy, MMPI-201 has been applied before and after surgery, in order to evaluate the mental state. For assessments of personal adjustment to the impairment and communication strategies, a communication personal profile has been applied preoperatively. RESULTS: more psychiatric disorders are present in the preoperative group compared to the general population and the postoperative group. These disorders are of exclusively a neurotic nature; the most frequent are depressive, anxious depressive and anxious reactions. A connection was found between adaptation style and facing strategies whether in the presence or absence of psychological disorders. CONCLUSION: the findings indicate a need for professional psychiatric-psychological support as a part of a rehabilitation program designed to reduce psychological difficulties, i.e. to help individuals to become adapted to the acoustic environment and to prevent or at least minimize the negative consequences of hearing impairment by efficient communication strategies.

Adaptation, Psychological↗

Mass family hysteria: a report from India.

The case of a 31-member family displaying mass hysteria in up to 10 members at one time is reported. The mass hysteria emerged in the context of the strong religious and cultural beliefs held by this closely knit family. The varied presentations included somatoform disorder, recurrent vomiting, conversion, dissociative and possession attacks. Two members had bipolar affective disorder that was recognized by the family as a 'medical' illness in contrast to other problems attributed to religiosity. The rarity of mass hysteria in a family and issues related to its medical and social management are highlighted.

Adolescent↗

Abnormalities in stress proteins in prion diseases.

1. Prion diseases include kuru, Creutzfeldt-Jakob disease (CJD), Gerstmann-Sträussler-Scheinker disease (GSS), and fatal familia insomnia (FFI) of humans, as well as scrapie and bovine spongiform encephalopathy (BSE) of animals. 2. All these disorders involve conversion of the normal, cellular prion protein (PrPC) into the corresponding scrapie isoform (PrPSc). PrPC adopts a structure rich in alpha-helices and devoid of beta-sheet, in contrast to PrPSc, which has a high beta-sheet content and is resistant to limited digestion by proteases. That a conformational transition features in the conversion of PrPC into PrPSc implies that prion diseases are disorders of protein conformation. 3. This concept has been extended by our studies with heat shock proteins (Hsp), many of which are thought to function as molecular chaperones. We found that the induction of some Hsps but not others was profoundly altered in scrapie-infected cells and that the distribution of Hsp73 is unusual in these cells. 4. Whether the conversion of PrPC into PrPSc is assisted by molecular chaperones, or if the accumulation of the abnormally folded PrPSc is complexed with Hsps remains to be established.

Animals↗

Recognizing and treating uncommon behavioral and emotional disorders in children and adolescents who have been severely maltreated: somatization and other somatoform disorders.

This article reviews current knowledge about somatoform disorders in children and adolescents. Somatoform disorders are likely to occur more frequently in children and adolescents who have been severely maltreated than in others. The symptoms of somatoform disorders are reviewed, strategies for distinguishing somatoform disorders from other disorders are examined, and treatment strategies are explored.

Adolescent↗

Functional weakness and sensory disturbance.

In the diagnosis of functional weakness and sensory disturbance, positive physical signs are as important as absence of signs of disease. Motor signs, particularly Hoover's sign, are more reliable than sensory signs, but none should be used in isolation and must be interpreted in the overall context of the presentation. It should be borne in mind that a patient may have both a functional and an organic disorder.

Conversion Disorder↗