title: Abreaction for conversion disorder: systematic review with meta-analysis.
abstract: BACKGROUND
  The value of drug interviews in the treatment of conversion disorder is at present unknown.
  
  
  OBJECTIVE
  To review all the available papers published in English that report on the use of drug interviews for treating conversion/dissociative disorder.
  
  
  METHODS
  Databases (including EMBASE, MEDLINE and PsycINFO) were searched from 1920 to 2009. Selected publications had to report on the use of drug interviews in people diagnosed with a conversion/dissociative disorder. Qualitative and quantitative data were extracted. Predictors of a positive response were ascertained using meta-analytic techniques.
  
  
  RESULTS
  Fifty-five papers meeting inclusion criteria were identified. No studies compared the intervention with a suitable control group. However, two studies reported high response rates when drug interview was used in individuals with treatment-resistant conversion disorder. In the meta-analysis, the use of suggestion and occurrence of emotional catharsis during the interview were positively associated with recovery. Combining two medications and comorbid psychiatric disorder were negatively associated with recovery.
  
  
  CONCLUSIONS
  The evidence for effectiveness of drug interviews is of poor quality but it may be of benefit in the treatment of acute and treatment-resistant conversion disorder. A proactive approach during the interview, making suggestions the individual will respond, could influence outcome. Comorbid psychiatric disorder should be treated conventionally. Experimental studies to determine efficacy are required.
authors.affiliation: St Bartholomew's Hospital, East London Foundation Trust, West Smithfield, London EC1A 7BE, UK. norman.poole@googlemail.com
authors.forename: Norman A
authors.initials: NA
authors.lastname: Poole
authors.forename: Axel
authors.initials: A
authors.lastname: Wuerz
authors.forename: Niruj
authors.initials: N
authors.lastname: Agrawal
mesh_terms: D000035:Abreaction; D001463:Barbiturates / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D003291:Conversion Disorder / Q000523:psychology / Q000628:therapy*; D004359:Drug Therapy, Combination; D005260:Female; D018757:GABA Modulators / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010919:Placebos; D012094:Repression, Psychology; D013404:Suggestion
chemical_list: D001463:Barbiturates; D018757:GABA Modulators; D010919:Placebos; D001569:Benzodiazepines