Childhood sexual abuse predicts treatment outcome in conversion disorder/functional neurological disorder. An observational longitudinal study

Objective Explore trauma, stress, and other predictive factors for treatment outcome in conversion disorder/functional neurological disorder (CD/FND). Methods Prospective observational design. Clinical cohort study among consecutive outpatients with DSM‐IV CD/FND in a specialized mental health insti...

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Published in:Brain and behavior 2020-03, Vol.10 (3), p.e01558-n/a
Main Authors: Van der Feltz‐Cornelis, Christina M., Allen, Sarah F., Van Eck van der Sluijs, Jonna F.
Format: Article
Language:English
Subjects:
Adult
Adult Survivors of Child Abuse - psychology
Adverse childhood experiences
Anxiety Disorders - psychology
Anxiety Disorders - therapy
Child sexual abuse
Childhood
childhood sexual abuse
Classification
Clinical outcomes
Comorbidity
Conversion disorder
Conversion Disorder - psychology
Conversion Disorder - therapy
Diagnostic and Statistical Manual of Mental Disorders
Female
functional neurological disorder
Humans
Longitudinal Studies
Male
Mental disorders
Mental health
Middle Aged
Neurological disorders
Original Research
Pathogenesis
Patients
predictive factors
Prognosis
Prospective Studies
Sex crimes
Sex Offenses - psychology
Stress
Studies
Surveys and Questionnaires
Trauma
Treatment Outcome
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description Objective Explore trauma, stress, and other predictive factors for treatment outcome in conversion disorder/functional neurological disorder (CD/FND). Methods Prospective observational design. Clinical cohort study among consecutive outpatients with DSM‐IV CD/FND in a specialized mental health institution for somatic symptom disorders and related disorders (SSRD), presented between 1 February 2010 and 31 December 2017. Patient files were assessed for early childhood trauma, childhood sexual abuse, current stress, and other predictive factors. Patient‐related routine outcome monitoring (PROM) data were evaluated for treatment outcome at physical (Patient Health Questionnaire [PHQ15], Physical Symptoms Questionnaire [PSQ]) level as primary outcome, and depression (Patient Health Questionnaire [PHQ9]), anxiety (General Anxiety Disorder [GAD7]), general functioning (Short Form 36 Health Survey [SF36]), and pain (Brief Pain Inventory [BPI]) as secondary outcome. Results A total of 64 outpatients were included in the study. 70.3% of the sample reported childhood trauma and 64.1% a recent life event. Mean scores of patients proceeding to treatment improved. Sexual abuse in childhood (F(1, 28) = 30.068, β = 0.608 p 
doi_str_mv 10.1002/brb3.1558
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An observational longitudinal study</title><source>Wiley Online Library Open Access</source><source>Publicly Available Content (ProQuest)</source><source>PubMed Central</source><creator>Van der Feltz‐Cornelis, Christina M. ; Allen, Sarah F. ; Van Eck van der Sluijs, Jonna F.</creator><creatorcontrib>Van der Feltz‐Cornelis, Christina M. ; Allen, Sarah F. ; Van Eck van der Sluijs, Jonna F.</creatorcontrib><description>Objective Explore trauma, stress, and other predictive factors for treatment outcome in conversion disorder/functional neurological disorder (CD/FND). Methods Prospective observational design. Clinical cohort study among consecutive outpatients with DSM‐IV CD/FND in a specialized mental health institution for somatic symptom disorders and related disorders (SSRD), presented between 1 February 2010 and 31 December 2017. Patient files were assessed for early childhood trauma, childhood sexual abuse, current stress, and other predictive factors. Patient‐related routine outcome monitoring (PROM) data were evaluated for treatment outcome at physical (Patient Health Questionnaire [PHQ15], Physical Symptoms Questionnaire [PSQ]) level as primary outcome, and depression (Patient Health Questionnaire [PHQ9]), anxiety (General Anxiety Disorder [GAD7]), general functioning (Short Form 36 Health Survey [SF36]), and pain (Brief Pain Inventory [BPI]) as secondary outcome. Results A total of 64 outpatients were included in the study. 70.3% of the sample reported childhood trauma and 64.1% a recent life event. Mean scores of patients proceeding to treatment improved. Sexual abuse in childhood (F(1, 28) = 30.068, β = 0.608 p &lt; .001) was significantly associated with worse physical (PHQ15, PSQ) treatment outcome. 42.2% reported comorbid depression, and this was significantly associated with worse concomitant depressive (PHQ9) (F[1, 39] = 11.526, β = 0.478, p = .002) and anxiety (GAD7) (F[1,34] = 7.950, β = 0.435, p = .008) outcome. Conclusion Childhood sexual abuse is significantly associated with poor treatment outcome in CD/FND. Randomized clinical trials evaluating treatment models addressing childhood sexual abuse in CD are needed. Childhood trauma occurs in 70.3% of patients with conversion disorder/FND. Childhood sexual abuse is significantly associated with poor treatment outcome for physical symptoms in patients with conversion disorder/FND. Randomized clinical trials evaluating treatment models addressing childhood sexual abuse in conversion disorder/FND are needed.</description><identifier>ISSN: 2162-3279</identifier><identifier>EISSN: 2162-3279</identifier><identifier>DOI: 10.1002/brb3.1558</identifier><identifier>PMID: 32031757</identifier><language>eng</language><publisher>United States: John Wiley &amp; Sons, Inc</publisher><subject>Adult ; Adult Survivors of Child Abuse - psychology ; Adverse childhood experiences ; Anxiety Disorders - psychology ; Anxiety Disorders - therapy ; Child sexual abuse ; Childhood ; childhood sexual abuse ; Classification ; Clinical outcomes ; Comorbidity ; Conversion disorder ; Conversion Disorder - psychology ; Conversion Disorder - therapy ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; functional neurological disorder ; Humans ; Longitudinal Studies ; Male ; Mental disorders ; Mental health ; Middle Aged ; Neurological disorders ; Original Research ; Pathogenesis ; Patients ; predictive factors ; Prognosis ; Prospective Studies ; Sex crimes ; Sex Offenses - psychology ; Stress ; Studies ; Surveys and Questionnaires ; Trauma ; Treatment Outcome</subject><ispartof>Brain and behavior, 2020-03, Vol.10 (3), p.e01558-n/a</ispartof><rights>2020 The Authors. published by Wiley Periodicals, Inc.</rights><rights>2020 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.</rights><rights>2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5098-7c6c906df0e01c1f49f6057a98ae37f6e0e4e500619eec62a579bf3c447dd7b53</citedby><cites>FETCH-LOGICAL-c5098-7c6c906df0e01c1f49f6057a98ae37f6e0e4e500619eec62a579bf3c447dd7b53</cites><orcidid>0000-0001-6925-8956 ; 0000-0003-0723-526X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2376064371/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2376064371?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11562,25753,27924,27925,37012,37013,44590,46052,46476,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32031757$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Van der Feltz‐Cornelis, Christina M.</creatorcontrib><creatorcontrib>Allen, Sarah F.</creatorcontrib><creatorcontrib>Van Eck van der Sluijs, Jonna F.</creatorcontrib><title>Childhood sexual abuse predicts treatment outcome in conversion disorder/functional neurological disorder. An observational longitudinal study</title><title>Brain and behavior</title><addtitle>Brain Behav</addtitle><description>Objective Explore trauma, stress, and other predictive factors for treatment outcome in conversion disorder/functional neurological disorder (CD/FND). Methods Prospective observational design. Clinical cohort study among consecutive outpatients with DSM‐IV CD/FND in a specialized mental health institution for somatic symptom disorders and related disorders (SSRD), presented between 1 February 2010 and 31 December 2017. Patient files were assessed for early childhood trauma, childhood sexual abuse, current stress, and other predictive factors. Patient‐related routine outcome monitoring (PROM) data were evaluated for treatment outcome at physical (Patient Health Questionnaire [PHQ15], Physical Symptoms Questionnaire [PSQ]) level as primary outcome, and depression (Patient Health Questionnaire [PHQ9]), anxiety (General Anxiety Disorder [GAD7]), general functioning (Short Form 36 Health Survey [SF36]), and pain (Brief Pain Inventory [BPI]) as secondary outcome. Results A total of 64 outpatients were included in the study. 70.3% of the sample reported childhood trauma and 64.1% a recent life event. Mean scores of patients proceeding to treatment improved. Sexual abuse in childhood (F(1, 28) = 30.068, β = 0.608 p &lt; .001) was significantly associated with worse physical (PHQ15, PSQ) treatment outcome. 42.2% reported comorbid depression, and this was significantly associated with worse concomitant depressive (PHQ9) (F[1, 39] = 11.526, β = 0.478, p = .002) and anxiety (GAD7) (F[1,34] = 7.950, β = 0.435, p = .008) outcome. Conclusion Childhood sexual abuse is significantly associated with poor treatment outcome in CD/FND. Randomized clinical trials evaluating treatment models addressing childhood sexual abuse in CD are needed. Childhood trauma occurs in 70.3% of patients with conversion disorder/FND. Childhood sexual abuse is significantly associated with poor treatment outcome for physical symptoms in patients with conversion disorder/FND. Randomized clinical trials evaluating treatment models addressing childhood sexual abuse in conversion disorder/FND are needed.</description><subject>Adult</subject><subject>Adult Survivors of Child Abuse - psychology</subject><subject>Adverse childhood experiences</subject><subject>Anxiety Disorders - psychology</subject><subject>Anxiety Disorders - therapy</subject><subject>Child sexual abuse</subject><subject>Childhood</subject><subject>childhood sexual abuse</subject><subject>Classification</subject><subject>Clinical outcomes</subject><subject>Comorbidity</subject><subject>Conversion disorder</subject><subject>Conversion Disorder - psychology</subject><subject>Conversion Disorder - therapy</subject><subject>Diagnostic and Statistical Manual of Mental Disorders</subject><subject>Female</subject><subject>functional neurological disorder</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Middle Aged</subject><subject>Neurological disorders</subject><subject>Original Research</subject><subject>Pathogenesis</subject><subject>Patients</subject><subject>predictive factors</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Sex crimes</subject><subject>Sex Offenses - psychology</subject><subject>Stress</subject><subject>Studies</subject><subject>Surveys and Questionnaires</subject><subject>Trauma</subject><subject>Treatment Outcome</subject><issn>2162-3279</issn><issn>2162-3279</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1kstqGzEUhofS0oQ0i75AEXTTLmzrMpJmNoXE9BIIFEq7FrqcsWXkkSvNuPVL9JmriZ2QFKqNdI4-Pg6Hv6peEzwnGNOFSYbNCefNs-qcEkFnjMr2-aP3WXWZ8waXw0lNa_yyOmMUMyK5PK_-LNc-uHWMDmX4PeqAtBkzoF0C5-2Q0ZBAD1voBxTHwcYtIN8jG_s9pOxjj5zPMTlIi27s7VA6RdHDmGKIK29LcQ_M0VWPosmQ9vrEhdiv_DA6PxW5PA6vqhedDhkuT_dF9ePTx-_LL7Pbr59vlle3M8tx28ykFbbFwnUYMLGkq9tOYC5122hgshOAoQaOsSAtgBVUc9majtm6ls5Jw9lFdXP0uqg3apf8VqeDitqru0ZMK6XT4G0AhcE4XDPWMqA1M9howxsBhnPbNLppi-vD0bUbzRacLbtKOjyRPv3p_Vqt4l5JLARjogjenQQp_hwhD2rrs4UQdA9xzIoyTgvYUFLQt_-gmzimsr6JkgKLmsmJen-kbIo5J-gehiFYTaFRU2jUFJrCvnk8_QN5H5ECLI7ALx_g8H-Tuv52ze6UfwE7OM93</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Van der Feltz‐Cornelis, Christina M.</creator><creator>Allen, Sarah F.</creator><creator>Van Eck van der Sluijs, Jonna F.</creator><general>John Wiley &amp; Sons, Inc</general><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6925-8956</orcidid><orcidid>https://orcid.org/0000-0003-0723-526X</orcidid></search><sort><creationdate>202003</creationdate><title>Childhood sexual abuse predicts treatment outcome in conversion disorder/functional neurological disorder. An observational longitudinal study</title><author>Van der Feltz‐Cornelis, Christina M. ; Allen, Sarah F. ; Van Eck van der Sluijs, Jonna F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5098-7c6c906df0e01c1f49f6057a98ae37f6e0e4e500619eec62a579bf3c447dd7b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Adult Survivors of Child Abuse - psychology</topic><topic>Adverse childhood experiences</topic><topic>Anxiety Disorders - psychology</topic><topic>Anxiety Disorders - therapy</topic><topic>Child sexual abuse</topic><topic>Childhood</topic><topic>childhood sexual abuse</topic><topic>Classification</topic><topic>Clinical outcomes</topic><topic>Comorbidity</topic><topic>Conversion disorder</topic><topic>Conversion Disorder - psychology</topic><topic>Conversion Disorder - therapy</topic><topic>Diagnostic and Statistical Manual of Mental Disorders</topic><topic>Female</topic><topic>functional neurological disorder</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Middle Aged</topic><topic>Neurological disorders</topic><topic>Original Research</topic><topic>Pathogenesis</topic><topic>Patients</topic><topic>predictive factors</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Sex crimes</topic><topic>Sex Offenses - psychology</topic><topic>Stress</topic><topic>Studies</topic><topic>Surveys and Questionnaires</topic><topic>Trauma</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Van der Feltz‐Cornelis, Christina M.</creatorcontrib><creatorcontrib>Allen, Sarah F.</creatorcontrib><creatorcontrib>Van Eck van der Sluijs, Jonna F.</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley-Blackwell Open Access Backfiles</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Brain and behavior</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van der Feltz‐Cornelis, Christina M.</au><au>Allen, Sarah F.</au><au>Van Eck van der Sluijs, Jonna F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Childhood sexual abuse predicts treatment outcome in conversion disorder/functional neurological disorder. An observational longitudinal study</atitle><jtitle>Brain and behavior</jtitle><addtitle>Brain Behav</addtitle><date>2020-03</date><risdate>2020</risdate><volume>10</volume><issue>3</issue><spage>e01558</spage><epage>n/a</epage><pages>e01558-n/a</pages><issn>2162-3279</issn><eissn>2162-3279</eissn><abstract>Objective Explore trauma, stress, and other predictive factors for treatment outcome in conversion disorder/functional neurological disorder (CD/FND). Methods Prospective observational design. Clinical cohort study among consecutive outpatients with DSM‐IV CD/FND in a specialized mental health institution for somatic symptom disorders and related disorders (SSRD), presented between 1 February 2010 and 31 December 2017. Patient files were assessed for early childhood trauma, childhood sexual abuse, current stress, and other predictive factors. Patient‐related routine outcome monitoring (PROM) data were evaluated for treatment outcome at physical (Patient Health Questionnaire [PHQ15], Physical Symptoms Questionnaire [PSQ]) level as primary outcome, and depression (Patient Health Questionnaire [PHQ9]), anxiety (General Anxiety Disorder [GAD7]), general functioning (Short Form 36 Health Survey [SF36]), and pain (Brief Pain Inventory [BPI]) as secondary outcome. Results A total of 64 outpatients were included in the study. 70.3% of the sample reported childhood trauma and 64.1% a recent life event. Mean scores of patients proceeding to treatment improved. Sexual abuse in childhood (F(1, 28) = 30.068, β = 0.608 p &lt; .001) was significantly associated with worse physical (PHQ15, PSQ) treatment outcome. 42.2% reported comorbid depression, and this was significantly associated with worse concomitant depressive (PHQ9) (F[1, 39] = 11.526, β = 0.478, p = .002) and anxiety (GAD7) (F[1,34] = 7.950, β = 0.435, p = .008) outcome. Conclusion Childhood sexual abuse is significantly associated with poor treatment outcome in CD/FND. Randomized clinical trials evaluating treatment models addressing childhood sexual abuse in CD are needed. Childhood trauma occurs in 70.3% of patients with conversion disorder/FND. Childhood sexual abuse is significantly associated with poor treatment outcome for physical symptoms in patients with conversion disorder/FND. Randomized clinical trials evaluating treatment models addressing childhood sexual abuse in conversion disorder/FND are needed.</abstract><cop>United States</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>32031757</pmid><doi>10.1002/brb3.1558</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0001-6925-8956</orcidid><orcidid>https://orcid.org/0000-0003-0723-526X</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adult
Adult Survivors of Child Abuse - psychology
Adverse childhood experiences
Anxiety Disorders - psychology
Anxiety Disorders - therapy
Child sexual abuse
Childhood
childhood sexual abuse
Classification
Clinical outcomes
Comorbidity
Conversion disorder
Conversion Disorder - psychology
Conversion Disorder - therapy
Diagnostic and Statistical Manual of Mental Disorders
Female
functional neurological disorder
Humans
Longitudinal Studies
Male
Mental disorders
Mental health
Middle Aged
Neurological disorders
Original Research
Pathogenesis
Patients
predictive factors
Prognosis
Prospective Studies
Sex crimes
Sex Offenses - psychology
Stress
Studies
Surveys and Questionnaires
Trauma
Treatment Outcome
title Childhood sexual abuse predicts treatment outcome in conversion disorder/functional neurological disorder. An observational longitudinal study
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