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Cited by 111Psychosomatic Disorders and Their TreatmentsPain Management and Placebo EffectPsychoanalysis and Psychopathology Research

The DOI matches its Crossref record; 36 of the 37 references it cites were found in a registry or an index.

Life events and escape in conversion disorder

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Nicholson, T. R., Aybek, S., Craig, T., Harris, T., Wojcik, W., David, A. S., Kanaan, R. A·2016·Psychological Medicine
DOI 10.1017/s0033291716000714PMC PMC4988265
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Abstract

BACKGROUND: Psychological models of conversion disorder (CD) traditionally assume that psychosocial stressors are identifiable around symptom onset. In the face of limited supportive evidence such models are being challenged. METHOD: Forty-three motor CD patients, 28 depression patients and 28 healthy controls were assessed using the Life Events and Difficulties Schedule in the year before symptom onset. A novel 'escape' rating for events was developed to test the Freudian theory that physical symptoms of CD could provide escape from stressors, a form of 'secondary gain'. RESULTS: CD patients had significantly more severe life events and 'escape' events than controls. In the month before symptom onset at least one severe event was identified in 56% of CD patients - significantly more than 21% of depression patients [odds ratio (OR) 4.63, 95% confidence interval (CI) 1.56-13.70] and healthy controls (OR 5.81, 95% CI 1.86-18.2). In the same time period 53% of CD patients had at least one 'high escape' event - again significantly higher than 14% in depression patients (OR 6.90, 95% CI 2.05-23.6) and 0% in healthy controls. Previous sexual abuse was more commonly reported in CD than controls, and in one third of female patients was contextually relevant to life events at symptom onset. The majority (88%) of life events of potential aetiological relevance were not identified by routine clinical assessments. Nine per cent of CD patients had no identifiable severe life events. CONCLUSIONS: Evidence was found supporting the psychological model of CD, the Freudian notion of escape and the potential aetiological relevance of childhood traumas in some patients. Uncovering stressors of potential aetiological relevance requires thorough psychosocial evaluation.

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Fig. 1. Total number of events during different epochs of the study. Note that epochs are not exclusive and the number of events in each epoch are converted to rate over 1 year (‘annualized’) allowing direct comparison between epochs of different lengths. Data on ‘last week’ and ‘last day’ epochs were not available for depression cases.
Fig. 1. Total number of events during different epochs of the study. Note that epochs are not exclusive and the number of events in each epoch are converted to rate over 1 year (‘annualized’) allowing direct comparison between epochs of different lengths. Data on ‘last week’ and ‘last day’ epochs were not available for depression cases.CC BY · PubMed Central

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Cites

Research works printed but not linked: 5

  1. Wing, 1974, The Measurement and Classification of Psychiatric Symptoms: An Instruction Manual for the Present State Examination and CATEGO Programme
  2. Brown, 1989, Life Events and Illness
  3. Rosenthal, 1963, The Genian Quadruplets, 505
  4. Nelson, 1991, National Adult Reading Test Manual
  5. 1992, The ICD-10 Classification of Mental and Behavioural Disorders

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Metadata

Authors
Nicholson, T. R., Aybek, S., Craig, T., Harris, T., Wojcik, W., David, A. S., & Kanaan, R. A.
Affiliations
  • King's College London (GB)
  • University of Geneva (CH)
  • The University of Melbourne (AU)
Corresponding author
Nicholson, T. R.
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2016-07-05
Volume
46
Issue
12
Pages
2617-2626
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291716000714
PMC
PMC4988265
OpenAlex
W2474723969
Cited by
110
References
37
Citations by year
2026: 6 · 2025: 13 · 2024: 6 · 2023: 7 · 2022: 14 · 2021: 8 · 2020: 17 · 2019: 14 · 2018: 14 · 2017: 9 · 2016: 2
FWCI
11.40
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychological Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by)
  • Research Portal (King's College London) (submittedVersion, cc-by)
Funders
  • National Institute for Health and Care Research
  • King's College London
  • Medical Research Council
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
conversion disorder, life events, escape, secondary gain, Freudian theory, psychosocial stressors, depression, child sexual abuse, symptom onset, psychosocial assessment
MeSH terms
Adult Survivors of Child Adverse Events, Adult, Conversion Disorder, Female, Humans, Life Change Events, Male, Middle Aged, Sex Offenses

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