Diagnostic stability of dissociative disorder during five year follow-up in tertiary hospital of Nepal

Abstract

Background: The stress on unconscious mind converted to physical symptoms or the disso­ciation of stress in to physical symptoms, called dissociative (conversion) disorder. The aim of the study was to identify diagnostic stability of dissociative (conversion) disorder during five years follow-up among patients with dissociative (conversion) disorder attending psychiatry department of Chitwan Medical College Teaching Hospital, Bharatpur, Nepal.

Methods: A prospective follow-up study was conducted among 253 patients with dissociative (conversion) disorder attending in the department of psychiatry of CMC-TH. Consecutive sampling technique was used to select the sample and data was collected through face to face interview method using structured interview schedule. Obtained data were analysed using ICD-10 DCR (Di­agnostic Criteria Research). The cases for study were taken during one year period. The follow up were done after 1 month, 1 year, 3 year and 5 year. The ratios and proportions were used for statistical analysis.

Results: After 5 years follow up, 72 patients did not come for regular follow-up visit i.e. Subject absent was 28.46%. out of 181 patients, highest percentage of patients were diagnosed as mania/ BPAD l (N-45, 24.86%) followed by depressive disorder (N-37,20.44 %), hypomania/BPAD II (N-24, 13.26%), and conversion disorder conversion disorder (N-8, 3.16%). More than one third (N´=64, 35.36%) of the patients were improved (N-64, 35.36%).

Conclusions: Diagnostic stability among patients with conversion disorders is very low after 5 years of follow up. They showed other disorders like mania/BPAD1, depressive disorder, hypomania/ BPAD II etc. Hence, regular follow-up and assessment using diagnostic criteria is essential for pa­tients with dissociative (conversion) disorder for their proper treatment.