title: Specialist inpatient treatment for severe motor conversion disorder: a retrospective comparative study.
abstract: BACKGROUND
  Gold standard protocols have yet to be established for the treatment of motor conversion disorder (MCD). There is limited evidence to support inpatient, multidisciplinary intervention in chronic, severe cases.
  
  
  OBJECTIVE
  To evaluate the characteristics and outcomes of MCD patients admitted to a specialist neuropsychiatric inpatient unit.
  
  
  METHODS
  All patients admitted to the Lishman Unit (years 2007-2011) with a diagnosis of MCD were included. Data relevant to characteristics and status with regard to mobility, activities of daily living (ADLs) and Modified Rankin Scale (MRS) score at admission and discharge were extracted.
  
  
  RESULTS
  Thirty-three cases (78.8% female) were included; the median duration of illness was 48 months. In comparison with brain injury patients admitted to the same unit, more cases had histories of childhood sexual abuse (36.4%, n=12), premorbid non-dissociative mental illness (81.1%, n=27) and employment as a healthcare/social-care worker (45.5%, n=15). Cases showed significant improvements in MRS scores (p<0.001), mobility (p<0.001) and ADL (p=0.002) following inpatient treatment.
  
  
  CONCLUSIONS
  Patients with severe, long-standing MCD can achieve significant improvements in functioning after admission to a neuropsychiatry unit.
authors.affiliation: National Institute for Health Research (NIHR) Biomedical Research Centre, South London & Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, UK Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King's College London, London, UK.
authors.forename: Ruaidhri
authors.initials: R
authors.lastname: McCormack
authors.affiliation: South London & Maudsley NHS Foundation Trust, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Moriarty
authors.affiliation: South London & Maudsley NHS Foundation Trust, London, UK.
authors.forename: John D
authors.initials: JD
authors.lastname: Mellers
authors.affiliation: South London & Maudsley NHS Foundation Trust, London, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Shotbolt
authors.affiliation: South London & Maudsley NHS Foundation Trust, London, UK.
authors.forename: Rosa
authors.initials: R
authors.lastname: Pastena
authors.affiliation: South London & Maudsley NHS Foundation Trust, London, UK.
authors.forename: Nadine
authors.initials: N
authors.lastname: Landes
authors.affiliation: Department of Psychology and NIHR Dementia Biomedical Research Unit at South London & Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Goldstein
authors.affiliation: South London & Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Fleminger
authors.affiliation: Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King's College London, London, UK.
authors.forename: Anthony S
authors.initials: AS
authors.lastname: David
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003291:Conversion Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007297:Inpatients; D038801:International Classification of Diseases; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D011237:Predictive Value of Tests; D011570:Psychiatry; D012189:Retrospective Studies; D012307:Risk Factors; D013038:Specialization; D016896:Treatment Outcome; D055815:Young Adult
keywords: MOVEMENT DISORDERS; NEUROPSYCHIATRY; REHABILITATION