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The role of alexithymia in the development of functional motor symptoms (conversion disorder).

Demartini, B; Petrochilos, P; Ricciardi, L; Price, G; Edwards, MJ; Joyce, E (2014) The role of alexithymia in the development of functional motor symptoms (conversion disorder). J Neurol Neurosurg Psychiatry, 85 (10). pp. 1132-1137. ISSN 1468-330X https://doi.org/10.1136/jnnp-2013-307203
SGUL Authors: Edwards, Mark John James

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Abstract

BACKGROUND: The mechanisms leading to the development of functional motor symptoms (FMS) are of pathophysiological and clinical relevance, yet are poorly understood. AIM: The aim of the present study was to evaluate whether impaired emotional processing at the cognitive level (alexithymia) is present in patients affected by FMS. We conducted a cross-sectional study in a population of patients with FMS and in two control groups (patients with organic movement disorders (OMD) and healthy volunteers). METHODS: 55 patients with FMS, 33 patients affected by OMD and 34 healthy volunteers were recruited. The assessment included the 20-item Toronto Alexithymia Scale (TAS-20), the Montgomery-Asberg Depression Rating Scale, the Reading the Mind in the Eyes' Test and the Structured Clinical Interview for Personality Disorders. RESULTS: Alexithymia was present in 34.5% of patients with FMS, 9.1% with OMD and 5.9% of the healthy volunteers, which was significantly higher in the FMS group (χ(2) (2)=14.129, p<0.001), even after controlling for the severity of symptoms of depression. Group differences in mean scores were observed on both the difficulty identifying feelings and difficulty describing feelings dimensions of the TAS-20, whereas the externally orientated thinking subscale score was similar across the three groups. Regarding personality disorder, χ(2) analysis showed a significantly higher prominence of obsessive-compulsive personality disorder (OCPD) in the FMS group (χ(2) (2)=16.217, p<0.001) and 71.4% of those with OCPD also reached threshold criteria for alexithymia. CONCLUSIONS: Because alexithymia is a mental state denoting the inability to identify emotions at a cognitive level, one hypothesis is that some patients misattribute autonomic symptoms of anxiety, for example, tremor, paraesthesiae, paralysis, to that of a physical illness. Further work is required to understand the contribution of OCPD to the development of FMS.

Item Type: Article
Additional Information: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
Keywords: NEUROPSYCHIATRY, Adult, Affective Symptoms, Case-Control Studies, Compulsive Personality Disorder, Conversion Disorder, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Movement Disorders, Psychiatric Status Rating Scales, Humans, Movement Disorders, Case-Control Studies, Cross-Sectional Studies, Affective Symptoms, Compulsive Personality Disorder, Conversion Disorder, Psychiatric Status Rating Scales, Adult, Middle Aged, Female, Male, Neurology & Neurosurgery, 11 Medical And Health Sciences, 17 Psychology And Cognitive Sciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Neuroscience (INCCNS)
Journal or Publication Title: J Neurol Neurosurg Psychiatry
ISSN: 1468-330X
Language: eng
Dates:
DateEvent
1 October 2014Published
9 September 2014Published Online
22 January 2014Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 3.0
PubMed ID: 24610939
Web of Science ID: WOS:000344456000230
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109517
Publisher's version: https://doi.org/10.1136/jnnp-2013-307203

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