conversiondisorder medically unexplained symptoms
Conditions
Interventions
The intervention includes the addition of practice with the mirror up to the
retirement program. For patients with an affected arm or hand mirror
arrangement consists of a vertically positioned mirr
Sponsors
Stichting Yulius (voorheen RMPI De Grote Rivieren)
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: • Six patients who meet the criteria for a motor conversion disorder according to the DSM-IV classification. • Patients participating in the low-stimulus program, which is part of the regular treatment • The motorconversion of the arm is monosymtpomatic (paresis or paralysis) • Symptoms last between two months and two years. • Age is between 18 and 65 years. • Patients are motivated for treatment. • Sufficient knowledge of Dutch language.
Exclusion criteria
Exclusion criteria: • Co-existence of a somatic condition that influences the conversion disorder • Psychotic symptoms. • Mental retardation • Concurrent treatment for conversion disorder in a different setting. • A condition which makes patients unsuitable for study participation, according to the researchers
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Gripstrength with the Jamar hand Meter Using a Handheld Digital Jamar dynamometer, the maximum hand grip strength will be measured daily in the affected hand. The grip strength is expressed digitally (kilograms). The dynamometer is a valid instrument for measuring hand grip strength (Mathiowetz, 2002). In this study at each measurement point three measurements are made, the highest score is taken. The interrater reliability was .82 (Mathiowetz et al, 1984), where the highest of three readings is used. The dynamometer is easy to use and the measurement takes little time (Bellac et al, 2000). Sensitivity to the Semmes Weinstein filaments Using monofilaments, the sensibility of all the fingers are determined. Semmes Weinstein filaments will be used, comprising a set of five different weights. This measurement is performed according to the protocol provided by the test. Although the test-retest reliability is better if the measurements are performed by a single tester (Bell-Krotoski & Tomancik, 1987), the test-retest reliability is also good for the five individual filaments as they are taken by different testers. | — |
Secondary
| Measure | Time frame |
|---|---|
| Brunnstrom Fugl-Meyer Assessment (BFM) The BFM is an instrument for handicrafts, which consists of 55 items scored on an ordinal 3-point scale (0-2). The overall test consists of an examination of the upper (hand and arm) and lower (leg and foot) limb and an examination of the balance. In this study, only the items for the upper extremity are taken. The maximum score for the upper extremity is 66. For the test area of the upper extremity is a high interrater reliability (ranging from .86 to .95) found in several studies (Sanford et al, 1993, Duncan et al, 1983). Construct validity of various studies and compared with several motor sizes ranged from .54 to .94 for the total score for the upper extremity (Sanford et al, 1993). Range of Motion (ROM) The normal range of motion is a joint range of motion (ROM) called. It refers to the amount of possible movement during non-assisted voluntary joint movement. The movement is thus provided by an active contraction of the muscles that span the joint. The opposition of the thumb to describe the degree of opposition against the digiti I, II, III, IV, V, and metacarpal V. The score ranges from 0 to 6. Dissociative Experiences Scale (DES) The DES (Carlson & Putnam, 1993, Bernstein & Putnam, 1986) is a self-report to measure dissociative symptoms. The questionnaire was translated into Dutch and Draijer by Boon (1993). The list includes 28 items and includes three factors: absorption, amnesia and depersonalization. The patient is asked to indicate on a visual analogue scale to indicate to what extent they experience dissociative sypmtoms. Several studies (Dubester & Braun, 1995; Frischoltz et al, 1990, Bernstein & Putnam, 1986) have shown that the realiability of the DES is very high. The test-retest reliability ranges from .84 to .93. The reliability over a period of one year showed relatively stable: .78 (Putnam et al, 1992). A meta-analysis (and Schuengel IJzendoorn, 1996) showed that the convergent | — |
Countries
Netherlands
Outcome results
None listed