Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Inselspital, University of Bern, Bern, Switzerland.
Swiss Med Wkly. 2010 Jan 9;140(1-2):12-7. doi: 10.4414/smw.2010.12776.
Although psychogenic aphonia is considered to be a conversion disorder, aphonic patients are primarily treated symptomatically. This is because it is considered of overriding importance to elicit a voice quickly to avoid fixation of the aphonia. The aim of this study was to show that, for patients exhibiting the symptom of voicelessness, not eliciting the voice immediately will not lead to a permanent aphonia.
Between February 2000 and May 2006, aphonia was diagnosed in 22 patients. Effects of short-term psychodynamic psychotherapeutic intervention and voice therapy were studied in a follow-up of three years, on average.
Twenty one patients recovered their voices; 6 even before their first medical examination, 13 after an average of 12 weeks and 2 patients after 2 and 3 years respectively. One patient who has been in psychiatric therapy for years, as a result of having suffered serious abuse, failed to regain her voice.
Even after a lengthy period of aphonia a complete recovery of the voice function is possible in nearly all cases. Countertransference phenomena in therapists are discussed as the possible reason why they usually decide on treatment aimed primarily at dealing with the symptoms.
虽然心因性失音被认为是一种转换障碍，但主要还是对失音患者进行对症治疗。这是因为尽快恢复声音被认为至关重要，以避免失音固定。本研究旨在表明，对于表现出声无力症状的患者，不立即发声不会导致永久性失音。
2000 年 2 月至 2006 年 5 月期间，诊断出 22 例失音患者。对他们进行了为期三年的短期精神动力心理治疗干预和语音治疗的随访研究。
21 名患者恢复了声音；6 名患者甚至在第一次就诊前就恢复了声音，13 名患者在平均 12 周后恢复了声音，2 名患者分别在 2 年和 3 年后恢复了声音。有一位患者由于遭受严重虐待，多年来一直在接受精神治疗，未能恢复她的声音。
即使经历了长时间的失音，几乎所有情况下都有可能完全恢复声音功能。治疗师的反移情现象被认为是他们通常决定主要针对症状进行治疗的原因。
