Abreaction for conversion disorder: systematic review with meta-analysis.
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.
Poole
Norman A
NA
St Bartholomew's Hospital, East London Foundation Trust, West Smithfield, London EC1A 7BE, UK. norman.poole@googlemail.com
Wuerz
Axel
A
Agrawal
Niruj
N
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
D001463:Barbiturates; D018757:GABA Modulators; D010919:Placebos; D001569:Benzodiazepines