Comorbid bipolar disorder among patients with conversion disorder

Abstract

Background: Psychiatric comorbidity rate among the patients with conversion disorder was reported between 31-71%. The present study was planned to assess the overall psychiatric comorbidity, particularly bipolar disorder comorbidity in patients with conversion disorder. Methods: A total of 100 consecutive patients admitted to the Psychiatric Emergency Unit of Sisli Etfal Teaching and Research Hospital in Istanbul, Turkey from April 2006 to November 2006 and diagnosed with conversion disorder were included in this study. SCID-I and sociodemographical form were administered to the patients. Results: Bipolar disorder was found in 28% of the patients. The rate of dissociative disorder not otherwise specified (NOS), panic disorder, eating disorder comorbidity were higher in conversion disorder patients with bipolar disorder. In comparison with unipolar patients, bipolar patients had significantly lower Global Assessment of Functioning scores (p=0.03). Conclusion: It is important to determine comorbidity and previous psychiatric history in patients with conversion disorder. If there is comorbid bipolar disorder, clinicians should consider mood stabilizing agents, and avoid antidepressants in the treatment of conversion disorder. Apart from other studies on conversion disorder, this study assessed comorbid bipolar disorder and other axis I diagnoses in patients with conversion disorder for the first time.

Keywords

• conversion disorder, bipolar disorder, comorbidity

Konversiyon bozukluğu hastalarında bipolar bozukluk komorbiditesi

Öz

Giriş: Konversiyon bozukluğu hastalarında psikiyatrik ekhastalık sıklığı %31-%71 arasında bildirilmiştir. Bu çalışmada konversiyon bozukluğu hastalarında başta iki uçlu bozukluk olmak üzere psikiyatrik ekhastalıkların değerendirilmesi planlanmıştır. Yöntem: Nisan 2006 ile Kasım 2006 arasında Şişli Etfal Eğitim ve Araştırma Hastanesi acil psikiyatri bölümüne başvuran ve konversiyon bozukluğu tanısı konulan 100 ardışık hasta çalışmaya dahil edildi. Hastalara SCID-I uygulandı ve sosyodemografik form dolduruldu. Bulgular: Hastaların %28’inde iki uçlu bozukluk saptandı. Başka türlü sınıflandırılamamış dissosiyatif bozukluk, panik bozukluk ve yeme bozukluğu ekhastalığı iki uçlu bozukluğu olan konversiyon hastalarında daha yüksek bulundu. Tek uçlu hastalara göre iki uçlu bozukluğu olan hastalarda anlamlı düzeyde düşük işevselliğin genel değerlendirilmesi skorları saptandı (p=0,03). Sonuç: Konversiyon bozukluğu hastalarında psikiyatrik öykü ve ekhastalığı belirlemek önemlidir. İki uçlu bozukluk ekhastalığı varsa klinisyenin konversiyon bozukluğu hastalarında antidepresan tedaviden kaçınmayı ve duygudurum dengeleyici eklemeyi gözönünde bulundurması gerekir. Diğer konversiyon bozukluğu çalışmalarından farklı olarak bu çalışmada yeni tanı konulmuş konversiyon bozukluğu hastalarında iki uçlu bozukluk ve diğer eksen I tanılarının ekhastalığı değerlendirilmiştir.

Anahtar Kelimeler

• konversiyon bozukluğu, iki uçlu bozukluk, ekhastalık

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