ArticlePsychological medicine2016
Life events and escape in conversion disorder.
Article in Psychological medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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Who cites it
35 citing papers in PubMed, 103 citations in OpenAlex.
- Randomised feasibility study evaluating eye movement desensitisation and reprocessing therapy for functional neurological disorder (MODIFI).Journal of neurology · 2025Trial
- Aetiological factors in functional seizures and functional motor symptoms: shared and distinct features.Journal of neurology, neurosurgery, and psychiatry · 2026Article
- Momentary predictors of dissociation in functional neurological disorder: an ecological momentary assessment-based pilot study.Frontiers in psychiatry · 2026Article
- Biopsychosocial interplay of personal injury insurance, legal frameworks, and functional neurological disorder: an emerging perspective on recovery and disability determinants.Frontiers in neurology · 2026Review
- Adverse life events and psychosocial stressors in functional neurological disorder: a retrospective cohort and case-control study using a large international electronic health record database.EClinicalMedicine · 2025Article
- Increased salivary oxytocin correlates with lower self-reported interoceptive accuracy in functional neurological disorders.Neurobiology of stress · 2025Article
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- Migraine and functional neurological disorder (FND)-a review of comorbidity and potential overlap.Brain communications · 2025Review
- Delineating network integration and segregation in the pathophysiology of functional neurological disorder.Brain communications · 2025Article
- Respiratory sensitivity is reduced in functional neurological disorder and associated with higher somatoform dissociation.Brain communications · 2025Article
- Functional Seizure Clinics: A Proposed Financially Viable Solution to the Neurologist Supply and Demand Mismatch.Neurology. Clinical practice · 2023Article
- Methylome changes associated with functional movement/conversion disorder: Influence of biological sex and childhood abuse exposure.Progress in neuro-psychopharmacology & biological psychiatry · 2023Article
- Article
- Myths and facts about functional neurological disorders: a cross-sectional study of knowledge and awareness among medical students and healthcare professionals in Iraq.BMJ neurology open · 2023Article
- Heterogeneity of patients with functional/dissociative seizures: Three multidimensional profiles.Epilepsia · 2022Article
- ASTASIA-ABASIA, PSYCHOGENIC OR ORGANIC? IT ́S NOT EASY.Actas espanolas de psiquiatria · 2022Article
- Combined Fainting and Psychogenic Non-epileptic Seizures as Significant Therapy Hurdles in Blood-Injury-Injection Phobia: A Mini-Review and Case Report.Frontiers in psychiatry · 2022Article
- Toward a possible trauma subtype of functional neurological disorder: Impact on symptom severity and physical health.Frontiers in psychiatry · 2022Article
- Early-life trauma endophenotypes and brain circuit-gene expression relationships in functional neurological (conversion) disorder.Molecular psychiatry · 2021Article
- A dimensional approach to functional movement disorders: Heresy or opportunity.Neuroscience and biobehavioral reviews · 2021Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 3 countries.
Funding
Abstract
backgroundPsychological models of conversion disorder (CD) traditionally assume that psychosocial stressors are identifiable around symptom onset. In the face of limited supportive evidence such models are being challenged.
methodForty-three motor CD patients, 28 depression patients and 28 healthy controls were assessed using the Life Events and Difficulties Schedule in the year before symptom onset. A novel 'escape' rating for events was developed to test the Freudian theory that physical symptoms of CD could provide escape from stressors, a form of 'secondary gain'.
resultsCD patients had significantly more severe life events and 'escape' events than controls. In the month before symptom onset at least one severe event was identified in 56% of CD patients - significantly more than 21% of depression patients [odds ratio (OR) 4.63, 95% confidence interval (CI) 1.56-13.70] and healthy controls (OR 5.81, 95% CI 1.86-18.2). In the same time period 53% of CD patients had at least one 'high escape' event - again significantly higher than 14% in depression patients (OR 6.90, 95% CI 2.05-23.6) and 0% in healthy controls. Previous sexual abuse was more commonly reported in CD than controls, and in one third of female patients was contextually relevant to life events at symptom onset. The majority (88%) of life events of potential aetiological relevance were not identified by routine clinical assessments. Nine per cent of CD patients had no identifiable severe life events.
conclusionsEvidence was found supporting the psychological model of CD, the Freudian notion of escape and the potential aetiological relevance of childhood traumas in some patients. Uncovering stressors of potential aetiological relevance requires thorough psychosocial evaluation.
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