Insights into Chronic Functional Movement Disorders: The Value of Qualitative Psychiatric Interviews

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• 作者：Steven A. Epstein ; M.D.^a ; ^{epsteins@gunet.georgetown.edu" class="auth_mail" title="E-mail the corresponding author} ; Carine W. Maurer ; M.D. ; Ph.D.^b ; Kathrin LaFaver ; M.D.^b ; ^c ; Rezvan Ameli ; Ph.D.^d ; Stephen Sinclair ; Ph.D.^e ; Mark Hallett ; M.D.^b
• 关键词：functional movement disorder ; psychogenic movement disorder ; conversion disorder ; qualitative ; interview.
• 刊名：Psychosomatics
• 出版年：2016
• 出版时间：November-December 2016
• 年：2016
• 卷：57
• 期：6
• 页码：566-575
• 全文大小：131 K

文摘

Patients with functional movement disorders (FMDs) are commonly seen by neurologists and psychosomatic medicine psychiatrists. Research literature provides scant information about the subjective experiences of individuals with this often chronic problem.

Objective

To enhance our understanding of psychologic aspects of FMDs by conducting qualitative interviews of research subjects.

Methods

In total, 36 patients with FMDs were recruited from the Human Motor Control clinic at the National Institutes of Health. Each subject participated in a qualitative psychiatric interview and a structured diagnostic psychiatric interview.

Results

Of our 36 subjects, 28 had current or lifetime psychiatric disorders in addition to conversion disorder and 22 had current disorders. Qualitative interviews provided rich information on patients’ understanding of their illnesses and impaired cognitive processing of emotions.

Conclusion

Our study supports the addition of open-ended qualitative interviews to delineate emotional dynamics and conceptual frameworks among such patients. Exploratory interviews generate enhanced understanding of such complex patients, above and beyond that gained by assessing DSM diagnostic comorbidities.