Characteristics and Outcomes of Children With Conversion Disorder Admitted to a Single Inpatient Rehabilitation Unit, A Retrospective Study.

BACKGROUND

Conversion disorder (CD) can lead to impaired functioning. Few studies present demographic and outcome data for pediatric patients. Many have had success with rehabilitation; however, further details are not known.

OBJECTIVE

To identify characteristics and outcomes of children admitted to a pediatric inpatient rehabilitation program with CD symptoms.

DESIGN

Retrospective study.

SETTING

Inpatient rehabilitation unit within a large children's hospital.

PATIENTS

All patients with diagnosis of CD or functional gait disorder (FGD) during designated time period.

METHODS

Data were obtained from chart review and United Data Systems for Medical Rehabilitation. Descriptive statistics and Wilcoxon signed rank tests were used to analyze data. A P value of <.05 was statistically significant.

OUTCOME MEASURES

Average length of stay, Functional Independence Measure for Children (WeeFIM) scores, WeeFIM change, WeeFIM efficiency, recommended therapies, number of repeat admissions to the same hospital for conversion disorder symptoms in the 12 months following discharge, and school reentry characteristics.

RESULTS

Thirty admissions were identified that met criteria. Before diagnosis, duration of symptoms was 58 ± 145 days, physician visits averaged 1.9 ± 2.1, hospital admissions to the same hospital averaged 0.7 ± 0.9, and absence from school was 6 ± 12 weeks. Overall, 83% exhibited mixed symptoms. Length of inpatient rehabilitation stay was 8.4 ± 4.2 days with WeeFIM score change of 30 ± 11.9 (P <.001). WeeFIM efficiency was 4.8 ± 4.1 points/d. For patients with documented WeeFIM scores at 3 months, all were improved or maintained. More than three-fourths (80%) had no documented readmission to the same hospital for CD symptoms for 1 year after discharge from inpatient rehabilitation. Close to half (47%) returned to school within 1 week of discharge from inpatient rehabilitation (when school was in session).

CONCLUSIONS

This study suggests that a multidisciplinary inpatient rehabilitation approach is a potentially effective and efficient treatment for children and adolescents with conversion disorder and leads to sustained functional improvement and return to school after discharge.

LEVEL OF EVIDENCE

III.