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THE HYSTERIA

Keywords: conversion disorder , presenting symptoms , area of living and precipitating stress

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Abstract:

Objectives: To find out the sociodemographic characteristics ofconversion disorders and to find if there is any difference between the presenting symptoms of rural and urbanpopulation. Design: A non-probability, purposive, hospital based sample. Place and Duration of Study: Psychiatrydepartment of Victoria Hospital Bahawalpur, from February 2004 to April 2005. Patients and Method: A sample of 100-patients was collected. Both sexes were included. DSM-IV criteria for conversion disorder were applied for diagnosisof all these patients. Informed consent was taken for inclusion in the study. Patients suffering from concurrent physicaldisorders were excluded. The first author (NM.) using a semi-structured pro-forma interviewed all these patients. Thesociodemographic characteristics and the clinical profile were collected. Statistical analysis was made with the statisticalpackage for windows, SPSS (version –10). The applied method for group comparison was chi square- test. Results:The mean age of patients from the urban area was 24.26±7.25 years, as compared to 22.15±7.49 years for thepatients from the rural area. Most of the patients were females and were married. Majority of the patients from the urbanas well as from the rural area were uneducated and from the lower socio-economic class. The onset of illness wastypically acute and sudden, with precipitating life event. Majority of the patients had family history of the illness and comorbidpsychiatric disorders. The presenting symptoms were either sensory, motor, mixed symptoms and psuedoseizures.The presenting symptoms of patient from both urban (p value of 0.008), and rural area (P value =0.013), werestatistically significant. There were no statistically significant association between the presenting symptoms and thearea of living. The p values of the entire chi square tests were greater than (0.05). Conclusion: Prompt elimination ofthe symptoms of conversion disorder is important to prevent secondary gains from reinforcing it and causing it to persistor reoccur. Psychiatric services need to be developed and updated for the provision of prompt and efficient treatment,for the patients with these chronic and sometimes disabling conversion disorders.

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