Psychogenic dyspnea and therapeutic chest radiograph.
Conversion disorders, the physical expression of unresolved psychological pain, can be associated with mourning. This case report is third in a series of articles by the authors on childhood mourning reflecting the effects of multiple losses (K. R. Kaufman & N. D. Kaufman, 2005; K. R. Kaufman & N. D. Kaufman, 2006). In this case report, perception of potential death (self or parent) after a motor vehicle accident precipitated psychogenic dyspnea. A "therapeutic" chest radiograph was an effective initial treatment. Rapid intervention with explanation of the functional nature of the conversion symptom, why this symptom developed, and how to address the underlying stresses in the future led to an excellent outcome. Psychosocial intervention should be included in the multidisciplinary approach toward the child with conversion disorder, be it in an ambulatory, ER, or inpatient setting. The clinician must remember that medically unexplained symptoms in childhood may represent a child's expression of mourning.
Kaufman
Kenneth R
KR
Department of Psychiatry and Neurology, UMDNJ--Robert Wood Johnson Medical School, 125 Paterson Street, Suite #2200, New Brunswick, New Jersey 08901, USA. kaufmakr@umdnj.edu
Endres
Jennifer K
JK
Kaufman
Nathaniel D
ND
D001293:Attitude to Death; D002648:Child; D003291:Conversion Disorder / Q000175:diagnosis / Q000628:therapy; D004417:Dyspnea / Q000209:etiology / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000628:therapy; D013902:Radiography, Thoracic; D013315:Stress, Psychological / Q000628:therapy