Woolie
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"Psychogenic movement disorder (PMD)" is a catch-all phrase for any patient presenting with a movement disorder whose features are inconsistent with a known neurological or other movement disorder. Assuming the person is not actually faking, then the underlying mechanism is considered to be psychosomatic. That is, psychological trauma is "converted" into a physical symptom.
Here are the Fahn and Williams (1988) criteria for diagnosis (excluding fakers). Note you need not have a co-morbid psychiatric diagnosis at all to fit any category, although such findings support the diagnosis (the most usual is depression or anxiety).
I have now read about 15 papers, and in none of these is there any justification given for the view that these are conversion disorders (its obvious, isn't it?) and there is no dissent whatsoever from this view! Treatment: psychotherapy and psychiatric medications, of course! Prognosis: poor. Some studies note a particularly poor prognosis for those silly patients who cling to the idea that they have a real physical illness (I seem to have heard that one before!)
Hey, and guess what? Turns out in actual fact, there's no evidence of higher rates of psychological trauma in this group than in matched controls. Plus, a recent study - link below - found that 80% of cases were precipitated by a physical illness. But did this challenge these authors' view of these disorders? Of course not! Obviously, these factors interact with psychological ones to generate the syndrome!
http://www.researchgate.net/profile..._disorders/links/0a85e53404b5a3db27000000.pdf
I suppose its possible there might in theory be such a thing as PMD - but the thing is, I can see no positive supporting evidence anywhere.
We think of our 21st century selves as so "scientific". But we have a total blindspot where it comes to statements about mind-body relations. They seem to have an evidential "free ride".
If I've learned anything from having CFS, its this!
Here are the Fahn and Williams (1988) criteria for diagnosis (excluding fakers). Note you need not have a co-morbid psychiatric diagnosis at all to fit any category, although such findings support the diagnosis (the most usual is depression or anxiety).
Clinically Established Psychogenic: Inconsistent or incongruent with classical dystonia. In addition, one or all of the following is highly suggestive: other neurologic signs present that are psychogenic (self-inflicted injuries, false weakness, false sensory findings), an obvious psychiatric disturbance is present, and multiple somatizations are present.
Probable Psychogenic: Movements are inconsistent or incongruent, but there are no supporting features OR movements are consistent with organic dystonia, but there are other psychogenic signs (as listed above), or multiple somatizations are present.
Possible Psychogenic: An obvious emotional disturbance is present, but movements are consistent with
organic dystonia.
Probable Psychogenic: Movements are inconsistent or incongruent, but there are no supporting features OR movements are consistent with organic dystonia, but there are other psychogenic signs (as listed above), or multiple somatizations are present.
Possible Psychogenic: An obvious emotional disturbance is present, but movements are consistent with
organic dystonia.
I have now read about 15 papers, and in none of these is there any justification given for the view that these are conversion disorders (its obvious, isn't it?) and there is no dissent whatsoever from this view! Treatment: psychotherapy and psychiatric medications, of course! Prognosis: poor. Some studies note a particularly poor prognosis for those silly patients who cling to the idea that they have a real physical illness (I seem to have heard that one before!)
Hey, and guess what? Turns out in actual fact, there's no evidence of higher rates of psychological trauma in this group than in matched controls. Plus, a recent study - link below - found that 80% of cases were precipitated by a physical illness. But did this challenge these authors' view of these disorders? Of course not! Obviously, these factors interact with psychological ones to generate the syndrome!
http://www.researchgate.net/profile..._disorders/links/0a85e53404b5a3db27000000.pdf
I suppose its possible there might in theory be such a thing as PMD - but the thing is, I can see no positive supporting evidence anywhere.
We think of our 21st century selves as so "scientific". But we have a total blindspot where it comes to statements about mind-body relations. They seem to have an evidential "free ride".
If I've learned anything from having CFS, its this!
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