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Psychopathology 2024Phenomenological literature has recently given much attention to the concept of atmosphere, which is the pre-individual affective tonality of the intersubjective space.... (Review)
Review
BACKGROUND
Phenomenological literature has recently given much attention to the concept of atmosphere, which is the pre-individual affective tonality of the intersubjective space. The importance of atmospheres in psychopathology has been described for various disorders, but little is known about the interaction with hysteria. The aim of the present paper was to describe the psychopathology of hysteria from the angle of the phenomenon of atmosphere, focussing on the hysterical person's peculiar "affective permeability".
SUMMARY
Hysterical people have difficulty defining themselves autonomously. As compensation, they adopt models transposed from the external environment such as social gender stereotypes or are influenced by the gaze and desire of others. They also possess a special sensitivity in perceiving the affectivity present in a given social situation, by which they are easily impressed and influenced. Their sensibility to environmental affectivity may allow them to take centre stage, assuming the postures and behaviours that others desire and that they sense by "sniffing" the atmosphere in which the encounter is immersed. Thus, a paradox may take place: sensibility is not mere passivity in hysteria but may become a tool for "riding" the emotional atmosphere and manipulating it.
KEY MESSAGES
Affective permeability to environmental atmospheres and manipulation of the environment are the two sides of the same coin. This overlap of passive impressionability and active manoeuvring is necessary to be grasped in the clinical encounter with hysterical persons not to be submerged by their theatricality, that is, by the hyper-intensive expressivity of their feelings and behaviours.
Topics: Humans; Hysteria; Emotions; Psychopathology
PubMed: 38109874
DOI: 10.1159/000535188 -
European Neurology 2016This historical essay outlines early ideas and clinical accounts of hysteria. It reproduces verbatim parts of a remarkable text of Thomas Sydenham. This provides the...
This historical essay outlines early ideas and clinical accounts of hysteria. It reproduces verbatim parts of a remarkable text of Thomas Sydenham. This provides the most detailed description of hysterical symptoms, contemporary treatment and particularly Sydenham's opinions about the nature of the disorder. His portrayal is compared to later and modern concepts and classification.
Topics: Dissociative Disorders; England; History, 17th Century; Humans; Hysteria; Somatoform Disorders
PubMed: 27658273
DOI: 10.1159/000450605 -
International Journal of Environmental... Jan 2023Functional neurological disorder (FND) is a common issue in the pediatric population. The concept and our understanding of functional neurological disorders have changed... (Review)
Review
Functional neurological disorder (FND) is a common issue in the pediatric population. The concept and our understanding of functional neurological disorders have changed over the past years, and new etiologic models and treatment plans have been explored. Knowledge about FND in the pediatric population, however, is lacking. The aim of this review is to provide an update on pediatric functional neurological disorder. We conducted a literature search of PubMed and SCOPUS databases and reviewed a total of 85 articles to gain insight into the current understanding of FND etiology, diagnosis, treatment, and prognosis in children and adolescents. Functional and high resolution MRI revealed abnormal connectivity and structural changes in patients with functional symptoms. The diagnostic criteria no longer require the presence of a psychological factor and instead focus on a rule-in diagnosis. Treatment of FND includes a clear communication of the diagnosis and the support of a multidisciplinary team. Although FND typically has a poor prognosis, better outcomes appear to have been achieved in children and young adults. We conclude that pediatric functional neurological disorder is a prevalent pathology and that this patient population has additional specific needs compared to the adult population.
Topics: Young Adult; Humans; Child; Adolescent; Nervous System Diseases; Conversion Disorder; Magnetic Resonance Imaging
PubMed: 36673871
DOI: 10.3390/ijerph20021099 -
Tijdschrift Voor Psychiatrie 2021Conversion and dissociation in their relationship have made a lot of pendulum movements over time between moving together and away from each other. In the run-up to the... (Review)
Review
BACKGROUND
Conversion and dissociation in their relationship have made a lot of pendulum movements over time between moving together and away from each other. In the run-up to the introduction of DSM-5, it was argued that conversion should be classified as a dissociative disorder, but this didn't happen.
AIM
In this article, the clinical scientific evidence is examined for the relationship between conversion and dissociation. We provide an overview of the recent clinical studies that examine both syndromes together. We also investigate the main overlapping predisposing characteristics and psychopathological explanatory models of both syndromes.
METHOD
Literature review in PubMed and PsycArticles.
RESULTS
Our findings confirm that there is a large comorbidity between conversive and dissociative symptoms in clinical reality. Both syndromes have a high prevalence of reported trauma and emotion dysregulation. However, evidence for present biomarkers is still llimited. The underlying explanation models are applicable for both conversion and dissociation.
CONCLUSION
We want to draw attention to the plea to bring conversion disorders back together with dissociative disorders. Moreover, the possible presence of trauma, the influential role of psychosocial stressors, the present psychiatric co-morbidity and the style of emotion regulation seem to justify the approach to conversion problems from a biopsychosocial perspective rather than from a purely biomedical perspective.
Topics: Comorbidity; Conversion Disorder; Diagnostic and Statistical Manual of Mental Disorders; Dissociative Disorders; Emotions; Humans
PubMed: 34231865
DOI: No ID Found -
Handbook of Clinical Neurology 2013
Review
Topics: Brain; Child; Conversion Disorder; Diagnosis, Differential; Humans; Prognosis
PubMed: 23622298
DOI: 10.1016/B978-0-444-52910-7.00010-6 -
Australian Family Physician Oct 2013Globus hystericus (GH) is a subjective feeling of a lump or foreign body in the throat thought to involve psychogenic factors, a form of somatisation disorder. The more...
Globus hystericus (GH) is a subjective feeling of a lump or foreign body in the throat thought to involve psychogenic factors, a form of somatisation disorder. The more modern terms, globus sensation or globus pharyngeus, reflect recognition of one or more possible contributing anatomico-physiological factors, such as gastro-oesophageal reflux disease (GORD) or pharyngeal inflammation.
Topics: Adolescent; Adult; Aged; Anxiety; Child; Child, Preschool; Conversion Disorder; Female; Gastroesophageal Reflux; Humans; Male; Middle Aged; Referral and Consultation; Young Adult
PubMed: 24130967
DOI: No ID Found -
The Journal of the American Board of... 2003
Topics: Aged; Diagnosis, Differential; Family Relations; Female; Histrionic Personality Disorder; Humans; Hysteria
PubMed: 14963087
DOI: 10.3122/jabfm.16.6.564 -
Academic Emergency Medicine : Official... Jun 2021We provide a narrative review of functional neurological disorder (FND, or conversion disorder) for the emergency department (ED). Diagnosis of FND has shifted from a... (Review)
Review
We provide a narrative review of functional neurological disorder (FND, or conversion disorder) for the emergency department (ED). Diagnosis of FND has shifted from a "rule-out" disorder to one now based on the recognition of positive clinical signs, allowing the ED physician to make a suspected or likely diagnosis of FND. PubMed, Google Scholar, academic books, and a hand search through review article references were used to conduct a literature review. We review clinical features and diagnostic pitfalls for the most common functional neurologic presentations to the ED, including functional limb weakness, functional (nonepileptic) seizures, and functional movement disorders. We provide practical advice for discussing FND as a possible diagnosis and suggestions for initial steps in workup and management plans.
Topics: Conversion Disorder; Emergency Service, Hospital; Humans; Seizures
PubMed: 33866653
DOI: 10.1111/acem.14263 -
Canadian Medical Association Journal Oct 1964Individuals can carry out complex activity while in a state of impaired consciousness, a condition termed "automatism". Consciousness must be considered from both an...
Individuals can carry out complex activity while in a state of impaired consciousness, a condition termed "automatism". Consciousness must be considered from both an organic and a psychological aspect, because impairment of consciousness may occur in both ways. Automatism may be classified as normal (hypnosis), organic (temporal lobe epilepsy), psychogenic (dissociative fugue) or feigned. Often painstaking clinical investigation is necessary to clarify the diagnosis. There is legal precedent for assuming that all crimes must embody both consciousness and will. Jurists are loath to apply this principle without reservation, as this would necessitate acquittal and release of potentially dangerous individuals. However, with the sole exception of the defence of insanity, there is at present no legislation to prohibit release without further investigation of anyone acquitted of a crime on the grounds of "automatism".
Topics: Automatism; Classification; Consciousness; Conversion Disorder; Crime; Diagnosis, Differential; Dissociative Disorders; Epilepsy; Epilepsy, Temporal Lobe; Forensic Medicine; Humans; Hypnosis; Hysteria; Malingering; Physiology; Temporal Lobe
PubMed: 14199824
DOI: No ID Found -
Journal of Neurology, Neurosurgery, and... Jul 2019At the interface between mind and body, psychiatry and neurology, functional neurological disorder (FND) remains poorly understood. Formerly dominant stress-related... (Review)
Review
At the interface between mind and body, psychiatry and neurology, functional neurological disorder (FND) remains poorly understood. Formerly dominant stress-related aetiological models have been increasingly challenged, in part due to cases without any history of past or recent trauma. In this perspective article, we review current evidence for such models, and how research into the role of traumatic stress in other disorders and the neurobiology of the stress response can inform our mechanistic understanding of FND. First, we discuss the association between stress and the onset or exacerbation of a variety of physical and mental health problems. Second, we review the role of hypothalamic-pituitary-adrenal axis dysfunction in the neurobiology of ill-health, alongside evidence for similar mechanisms in FND. Third, we advocate a stress-diathesis model, in which biological susceptibility interacts with early life adversity, where FND can be precipitated by traumatic events later in life and maintained by psychological responses. We hypothesise that greater biological susceptibility to FND is associated with less severe remote and recent stress, and that FND precipitated by more severe stress is associated with lower biological vulnerability. This would explain clinical experience of variable exposure to historical and recent traumatic stress among people with FND and requires empirical investigation. A testable, evidence-based stress-diathesis model can inform nuanced understanding of how biological and psychological factors interact at the individual level, with potential to inform personalised treatment pathways. Much-needed research to establish the aetiology of FND will enhance clinical care and communication, facilitate effective treatment and inform prevention strategies.
Topics: Conversion Disorder; Humans; Models, Biological; Stress, Psychological
PubMed: 30409887
DOI: 10.1136/jnnp-2018-318297