M Hubschmid1, S Aybek2, G E Maccaferri3, O Chocron4, M M Gholamrezaee5, A O Rossetti6, F Vingerhoets7, A Berney8. 1. Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital (CHUV), Rue du Bugnon 44, 1011 Lausanne, Switzerland. Electronic address: monica.hubschmid@vidymed.ch. 2. Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), Rue du Bugnon 44, 1011 Lausanne, Switzerland. Electronic address: selma.aybek@unige.ch. 3. Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital (CHUV), Rue du Bugnon 44, 1011 Lausanne, Switzerland. Electronic address: giorgio.maccaferri@chuv.ch. 4. Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital (CHUV), Rue du Bugnon 44, 1011 Lausanne, Switzerland. Electronic address: oury.chocron@chuv.ch. 5. Department of Psychiatry, Lausanne University Hospital (CHUV), Rue du Bugnon 44, 1011 Lausanne, Switzerland. Electronic address: mehdi.gholam@chuv.ch. 6. Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), Rue du Bugnon 44, 1011 Lausanne, Switzerland. Electronic address: andrea.rossetti@chuv.ch. 7. Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), Rue du Bugnon 44, 1011 Lausanne, Switzerland. Electronic address: francois.vingerhoets@chuv.ch. 8. Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital (CHUV), Rue du Bugnon 44, 1011 Lausanne, Switzerland. Electronic address: alexandre.berney@chuv.ch.
Abstract
OBJECTIVE: The objective was to compare a brief interdisciplinary psychotherapeutic intervention to standard care as treatments for patients recently diagnosed with severe motor conversion disorder or nonepileptic attacks. METHODS: This randomized controlled trial of 23 consecutive patients compared (a) aninterdisciplinary psychotherapeutic intervention group receiving four to six sessions by a consultation liaison psychiatrist, the first and last sessions adding a neurological consultation and a joint psychiatric and neurological consultation, and (b) a standard care group. After intervention, patients were assessed at 2, 6 and 12 months with the Somatoform Dissociation Questionnaire (SDQ-20), Clinical Global Impression scale, Rankin scale, use of medical care, global mental health [Montgomery and Asberg Depression Rating Scale, Beck Depression Inventory, mental health component of Short Form (SF)-36] and quality of life (SF-36). We calculated linear mixed models. RESULTS: Our intervention brought a statistically significant improvement of physical symptoms [as measured by the SDQ-20 (P<.02) and the Clinical Global Impression scale (P=.02)] and psychological symptoms [better scores on the mental health component of the SF-36 (P<.05) and on the Beck Depression Inventory (P<.05)] and a reduction in new hospital stays after intervention (P<.05). CONCLUSION: A brief psychotherapeutic intervention taking advantage of a close collaboration with neurology consultants in the setting of consultation liaison psychiatry appears effective.
RCT Entities:
OBJECTIVE: The objective was to compare a brief interdisciplinary psychotherapeutic intervention to standard care as treatments for patients recently diagnosed with severe motor conversion disorder or nonepileptic attacks. METHODS: This randomized controlled trial of 23 consecutive patients compared (a) an interdisciplinary psychotherapeutic intervention group receiving four to six sessions by a consultation liaison psychiatrist, the first and last sessions adding a neurological consultation and a joint psychiatric and neurological consultation, and (b) a standard care group. After intervention, patients were assessed at 2, 6 and 12 months with the Somatoform Dissociation Questionnaire (SDQ-20), Clinical Global Impression scale, Rankin scale, use of medical care, global mental health [Montgomery and Asberg Depression Rating Scale, Beck Depression Inventory, mental health component of Short Form (SF)-36] and quality of life (SF-36). We calculated linear mixed models. RESULTS: Our intervention brought a statistically significant improvement of physical symptoms [as measured by the SDQ-20 (P<.02) and the Clinical Global Impression scale (P=.02)] and psychological symptoms [better scores on the mental health component of the SF-36 (P<.05) and on the Beck Depression Inventory (P<.05)] and a reduction in new hospital stays after intervention (P<.05). CONCLUSION: A brief psychotherapeutic intervention taking advantage of a close collaboration with neurology consultants in the setting of consultation liaison psychiatry appears effective.
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