Aims: To compare the frequency of life events in the year
preceding illness onset in a series of Conversion Disorder
(CD) patients, with those of a matched control group and
to characterize the nature of those events in terms of
"escape" potential. Traditional models of CD hypothesise
that relevant stressful experiences are "converted" into
physical symptoms to relieve psychological pressure,
and that the resultant disability allows "escape" from the
stressor, providing some advantage to the individual.
Methods: The Life Events and Difficulties Schedule
(LEDS) is a validated semi-structured interview
designed to minimise recall and interviewer bias through
rigorous assessment and independent rating of events.
An additional "escape" rating was developed.
Results: In the year preceding onset in 25 CD patients
(mean age 38.9 years ± 8) and a similar matched period
in 13 controls (mean age 36.2 years ± 10), no significant
difference was found in the proportion of subjects having
≥ 1 severe event (CD 64%, controls 38%; p=0.2). In the
last month preceding onset, a higher number of patients
experienced ≥1 severe events than controls (52% vs 15%,
odds ratio 5.95 (CI: 1.09-32.57)). Patients were twice as
much more likely to have a severe escape events than
controls, in the month preceding onset (44% vs 7%, odds
ratio 9.43 (CI: 1.06-84.04).
Conclusion: Preliminary data from this ongoing study
suggest that the time frame (preceding month) and the
nature ("escape") of the events may play an important
role in identifying key events related to CD onset.