Psychogenic aphonia: no fixation even after a lengthy period of aphonia.
BACKGROUND
Although psychogenic aphonia is considered to be a conversion disorder, aphonic patients are primarily treated symptomatically. This is because it is considered of overriding importance to elicit a voice quickly to avoid fixation of the aphonia. The aim of this study was to show that, for patients exhibiting the symptom of voicelessness, not eliciting the voice immediately will not lead to a permanent aphonia.


METHODS
Between February 2000 and May 2006, aphonia was diagnosed in 22 patients. Effects of short-term psychodynamic psychotherapeutic intervention and voice therapy were studied in a follow-up of three years, on average.


RESULTS
Twenty one patients recovered their voices; 6 even before their first medical examination, 13 after an average of 12 weeks and 2 patients after 2 and 3 years respectively. One patient who has been in psychiatric therapy for years, as a result of having suffered serious abuse, failed to regain her voice.


CONCLUSIONS
Even after a lengthy period of aphonia a complete recovery of the voice function is possible in nearly all cases. Countertransference phenomena in therapists are discussed as the possible reason why they usually decide on treatment aimed primarily at dealing with the symptoms.
Kolbrunner
Juerg
J
Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Inselspital, University of Bern, Bern, Switzerland. juerg.kollbrunner@insel.ch
Menet
Anne-Dorine
AD
Seifert
Eberhard
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D001044:Aphonia / Q000523:psychology / Q000628:therapy*; D002648:Child; D003291:Conversion Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014834:Voice Training; D055815:Young Adult