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[早发性转换障碍:一例报告]

[Early onset conversion disorder: a case report].

作者信息

Akdemir Devrim, Unal Fatih

机构信息

Hacettepe U Tip Fak, Cocuk Ruh Sağliği ve Hastaliklari AD, Ankara.

出版信息

Turk Psikiyatri Derg. 2006 Spring;17(1):65-71.

Abstract

Conversion disorder is defined as the presence of functional impairment in motor, sensory and neurovegetative systems that cannot be fully explained by a general medical condition. In western countries, conversion disorder is rare in children and adolescents. However, clinical studies from our country demonstrated a high frequency of conversion disorder diagnosis in child and adolescent psychiatry clinics. Conversion disorder is more frequently seen in adolescents and young adults compared to children. The likelihood of this disorder in children younger than five years of age is very low. This case report presents an 8 years old patient with conversion disorder diagnosis whose complaints started at three years of age. Her clinical condition had been continuous and resistant to non-psychiatric treatment approaches. Her complaints included inability to stand up and walk, complete bed dependence, presence of jerking type of movements in both legs, contractures as a result of decreased muscle movements and joint use, and presence of curving in her back due to continuous sitting bent to one side. Therapeutic interventions had been successful and the patient completely recovered. In this paper, the clinical presentation of conversion disorder, possible etiological factors and how these factors were handled, concrete treatment strategies and the follow-up of this patient are discussed. In addition, importance of early diagnosis and treatment of conversion disorder in children in our country and requirement of interdisciplinary cooperation in treatment are emphasized.

摘要

转换障碍被定义为运动、感觉和神经植物神经系统存在功能损害,而这种损害不能完全用一般躯体疾病来解释。在西方国家,转换障碍在儿童和青少年中很少见。然而,我国的临床研究表明,在儿童和青少年精神科门诊中,转换障碍的诊断频率很高。与儿童相比,转换障碍在青少年和青年中更为常见。5岁以下儿童患这种障碍的可能性非常低。本病例报告介绍了一名8岁被诊断为转换障碍的患者,其症状始于3岁。她的临床状况持续存在,且对非精神科治疗方法无反应。她的症状包括无法站立和行走、完全依赖卧床、双腿出现抽搐样运动、由于肌肉运动和关节活动减少导致挛缩,以及由于持续向一侧弯腰坐着而导致背部弯曲。治疗干预取得了成功,患者完全康复。本文讨论了转换障碍的临床表现、可能的病因因素以及如何处理这些因素、具体的治疗策略以及该患者的随访情况。此外,强调了我国儿童转换障碍早期诊断和治疗的重要性以及治疗中跨学科合作的必要性。

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