Abreaction for conversion disorder: systematic review with meta-analysis.

Autor:	Poole NA; St Bartholomew's Hospital, East London Foundation Trust, West Smithfield, London EC1A 7BE, UK. norman.poole@googlemail.com, Wuerz A, Agrawal N
Jazyk:	angličtina
Zdroj:	The British journal of psychiatry : the journal of mental science [Br J Psychiatry] 2010 Aug; Vol. 197 (2), pp. 91-5.
DOI:	10.1192/bjp.bp.109.066894
Abstrakt:	Background: The value of drug interviews in the treatment of conversion disorder is at present unknown. Aims: To review all the available papers published in English that report on the use of drug interviews for treating conversion/dissociative disorder. Method: Databases (including EMBASE, MEDLINE and PsycINFO) were searched from 1920 to 2009. Selected publications had to report on the use of drug interviews in people diagnosed with a conversion/dissociative disorder. Qualitative and quantitative data were extracted. Predictors of a positive response were ascertained using meta-analytic techniques. Results: Fifty-five papers meeting inclusion criteria were identified. No studies compared the intervention with a suitable control group. However, two studies reported high response rates when drug interview was used in individuals with treatment-resistant conversion disorder. In the meta-analysis, the use of suggestion and occurrence of emotional catharsis during the interview were positively associated with recovery. Combining two medications and comorbid psychiatric disorder were negatively associated with recovery. Conclusions: The evidence for effectiveness of drug interviews is of poor quality but it may be of benefit in the treatment of acute and treatment-resistant conversion disorder. A proactive approach during the interview, making suggestions the individual will respond, could influence outcome. Comorbid psychiatric disorder should be treated conventionally. Experimental studies to determine efficacy are required.
Databáze:	MEDLINE
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