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Klinische behandeling van zestien patiënten met een motorische conversiestoornis; een ‘pilot–study’

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Samenvatting

In dit artikel worden het behandelprogramma, de behandelresultaten en een aantal patiëntgegevens beschreven van klinische studies in Dordrecht en Delft. De studies fungeerden als ‘pilot’ voor een zich in een vergevorderd stadium bevindend onderzoeksproject naar het resultaat van hypnotherapie in de klinische en ambulante behandeling van patiënten met een motorische conversiestoornis. Na enkele inleidende opmerkingen over de problemen bij de interpretatie van onderzoeksgegevens, wordt relevante literatuur over de klinische behandelresultaten van patiënten met deze stoornis besproken. Daarna worden de elementen uitgewerkt van het gebruikte behandelprogramma. Dit bestaat uit interventies die gericht zijn op het lichamelijk functioneren en uit psychologische interventies, waaronder hypnotherapie. De positieve resultaten van de studies lijken aan te tonen dat het de moeite waard is om het effect van klinische behandeling, waarbij ook gebruik wordt gemaakt van hypnose, te onderzoeken in gecontroleerde klinische trials. Bij de interpretatie van de resultaten zou vooral aandacht moeten worden gegeven aan de primaire diagnose (met name somatisatiestoornis), duur van de klachten, traumatische ervaringen in de jeugdjaren, dissociatieve capaciteiten, hypnotiseerbaarheid en aanwezigheid van pijn.

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Notes

  1. De patiënten konden meer dan één symptoom hebben; vandaar dat het totale aantal symptomen hoger is dan het aantal patiënten

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    Franny Moene

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  1. Franny Moene
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  2. Kees Hoogduin
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Abstract

The inpatient psychiatric treatment of sixteen patients suffering from a motor conversion disorder, and reports on treatment outcome are described. The studies were used as a pilot study for an ongoing research project on the effect of hypnosis in the treatment of motor conversion disorder. Some introductory comments on the problems of interpretation of research information are followed by a discussion of the literature pertaining to the results of the inpatient treatment of conversion disorders. Some detail is then given on the treatment programme followed, which consists of interventions directed towards physical functioning and psychological interventions, including hypnosis. The positive results of these studies suggest that comprehensive clinical treatment including hypnosis for conversion disorders has enough promise to be studied in controlled clinical trials. In the interpretation of results, special attention should be given to the primary diagnosis (especially somatization disorder), duration of complaints, traumatic experiences in childhood, dissociative capacity, hypnotizability and presence of pain.

Drs. F.C. Moene, psycholoog/psychotherapeut, is hoofd van de polikliniek voor volwassenen van het algemeen psychiatrisch ziekenhuis De Grote Rivieren te Dordrecht; zij is tevens werkzaam op de speciale conversie–afdeling. Dr. C.A.L. Hoogduin, zenuwarts, is hoogleraar psychopathologie aan de vakgroep Klinische psychologie en persoonlijkheidsleer van de KU Nijmegen. Hij is managing partner van de psychologenpraktijk HSK te Nijmegen.

>Correspondentieadres: Mevrouw drs. F.C. Moene, Algemeen psychiatrisch ziekenhuis De Grote Rivieren, Overkampweg 115, 3318 AR Dordrecht.

Om redenen van herkenbaarheid wordt in dit artikel voor de beschreven klachten de DSM–IV–classificatie ‘conversiestoornis’ gebruikt. Er zijn argumenten om aan te nemen dat de conversiestoornis dissociatief van karakter is en daarom beter recht wordt gedaan in de ICD –10–classificatie (International classification of disorders, 1992) als ‘dissociative motor disorder’

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Moene, F., Hoogduin, K. Klinische behandeling van zestien patiënten met een motorische conversiestoornis; een ‘pilot–study’. DITH 16, 120–128 (1996). https://doi.org/10.1007/BF03060147

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