About the ads

  1. Free Financial Webinar with White Coat Investor! Monday evening at 7:00 PM EDT, hear about the Top 5 Financial Considerations for Starting Residents from White Coat Investor's Dr. James Dahle. Register here. Hope to see you there!

12 girls in NY with ... conversion disorder?

Discussion in 'Psychiatry' started by cbrons, Jan 18, 2012.

  1. SDN is a nonprofit organization. Services are made possible through the generous support of SDN members and sponsors. Thank you.
  1. cbrons

    cbrons love machine

    Joined:
    Jul 29, 2007
    Messages:
    4,740
    Location:
    The dog LB
    Status:
    Medical Student
    SDN 7+ Year Member
  2. billypilgrim37

    billypilgrim37 Unstuck in Time

    Joined:
    Apr 21, 2007
    Messages:
    2,400
    Status:
    Attending Physician
    Physician Faculty SDN 7+ Year Member
  3. NoNoNoNo

    NoNoNoNo

    Joined:
    Sep 13, 2011
    Messages:
    110
    Status:
    Medical Student
    I just spent waaaay too long reading those comments.
  4. billypilgrim37

    billypilgrim37 Unstuck in Time

    Joined:
    Apr 21, 2007
    Messages:
    2,400
    Status:
    Attending Physician
    Physician Faculty SDN 7+ Year Member
    Distressingly hypnotic, aren't they?
  5. cbrons

    cbrons love machine

    Joined:
    Jul 29, 2007
    Messages:
    4,740
    Location:
    The dog LB
    Status:
    Medical Student
    SDN 7+ Year Member
    So what's the appropriate treatment going to (likely) be?
  6. splik

    splik

    Joined:
    Nov 30, 2009
    Messages:
    1,405
    Status:
    Resident [Any Field]
    Physician SDN 2+ Year Member
    The facebook comments were rather hysterical themselves! I would strongly recommend Hystories: hysterical epidemics and modern cultures by Elaine Showalter.

    The problem here is that it sounds like they were told the problem was 'psychological' which I would never tell to any patient with a conversion disorder, nor would any good neurologist. People assume 'psychological' means 'I'm making it up' or 'its all in my head' and if you keep having to prove that you are 'ill' how can you ever get better? Using the term hysteria in the media isn't going to help and I would be surprised if this didn't spread, assuming this was a conversion.

    If you get to conversion symptoms early enough then treatment with hypnosis is very effective. The patients I have had with conversion disorder have been highly highly hypnotizable, very suggestible, and it has been a real treat to use hypnosis either for symptom removal or within a cognitive-behavioral or dynamic (interpersonal) framework. Once symptoms have been present for weeks and months then things become more difficult. CBT is one of the more popular treatments in Europe but actually the evidence base is non existent. Theoretically psychoanalytic treatments should work, but in reality they don't. Part of this is that you have to really engage the patients with your approach and most patients are unwilling to accept a psychological discourse for what is happening.

    Interestingly there is a lot of research showing that conversion really is a dissociative disorder, with dissociation between limbic activity and motor/sensory activity functionally in the brain. Also the neurobiology of hypnosis and dissociation are pretty much identical.

    Usually in more chronic symptoms you give the patient 'a way out' such as physiotherapy, neuro OT, treating the deficit how you would otherwise. Unfortunately there is a high morbidity with these sorts of symptoms, and often they don't improve all that much. The major problem is the message the physicians convey to patients by doing all sorts of investigations which are anxiogenic when they prove to be negative - 'there must be something serious wrong, that no one can find out, why else are they doing all of these tests?' etc.
  7. PETRAN

    PETRAN

    Joined:
    Dec 28, 2010
    Messages:
    187
    Status:
    Psychology Student
    SDN 2+ Year Member
    PANDAS more likely i say
  8. nitemagi

    nitemagi Senior Member

    Joined:
    Oct 15, 2001
    Messages:
    2,258
    Location:
    Los Angeles, CA
    Status:
    Attending Physician
    Physician Faculty SDN 10+ Year Member
    PANDAS is controversial at best and fairly uncommon. I'm not aware of PANDAS "clusters," though would love to see any data disputing that.

    http://www.ncbi.nlm.nih.gov/pubmed/21308506
  9. PETRAN

    PETRAN

    Joined:
    Dec 28, 2010
    Messages:
    187
    Status:
    Psychology Student
    SDN 2+ Year Member

    Well, a whole group of people developing "conversion-tourette" overnight isn't exactly common and uncontroversial :laugh:



    Sorry, but i'm a fan of occam's razor
  10. nitemagi

    nitemagi Senior Member

    Joined:
    Oct 15, 2001
    Messages:
    2,258
    Location:
    Los Angeles, CA
    Status:
    Attending Physician
    Physician Faculty SDN 10+ Year Member
    You're moreso demonstrating crabtree's bludgeon, actually.
  11. PETRAN

    PETRAN

    Joined:
    Dec 28, 2010
    Messages:
    187
    Status:
    Psychology Student
    SDN 2+ Year Member

    Depending on my borderline flactuating attitudes sometimes i prefer hickam's dictum
  12. Ibid

    Ibid

    Joined:
    Jun 21, 2010
    Messages:
    626
    SDN 2+ Year Member
    Sam would use ibids rule: Rely on what you knew was right before you bothered to think about it.

    [YOUTUBE]http://www.youtube.com/watch?v=PB-wmOYelnM&feature=related[/YOUTUBE]
  13. billypilgrim37

    billypilgrim37 Unstuck in Time

    Joined:
    Apr 21, 2007
    Messages:
    2,400
    Status:
    Attending Physician
    Physician Faculty SDN 7+ Year Member
    Let's assume for one second that PANDAS is real. We just don't know. It is suspicious that the same people who talk about PANDAS all the time tend to be the "vaccines cause autism" and "chronic lyme disease causes everything" crowds...

    PANDAS makes ZERO sense here! Assuming PANDAS is real, even if you gave a bunch of kids a strep infection, only a very small percentage of them would be expected to demonstrate tics or OC behaviors. Strep infections already get passed around like crazy at pretty much all schools. Even if this were PANDAS, then the question would become even crazier as to why all these girls in the same area would get it.

    My dad works in an oil refinery. 4 out of about 300 guys there have developed Guillan-Barre in the last five years. Now THAT is evidence of some sort of environmental factor causing something. 12 cases of PANDAS in a school violates everything we (might) know about PANDAS.
  14. PETRAN

    PETRAN

    Joined:
    Dec 28, 2010
    Messages:
    187
    Status:
    Psychology Student
    SDN 2+ Year Member


    Its a very aggressive basal-ganglia-friendly strep god damnit!


    If not pandas then Lyme! :mad: :sleep:
  15. billypilgrim37

    billypilgrim37 Unstuck in Time

    Joined:
    Apr 21, 2007
    Messages:
    2,400
    Status:
    Attending Physician
    Physician Faculty SDN 7+ Year Member
    Dude, you just made my night. I laughed for like 45 seconds straight. Rock on. ;)
  16. surftheiop

    surftheiop

    Joined:
    Dec 4, 2008
    Messages:
    1,942
    SDN 2+ Year Member
    Hmm patients are a bunch of highschool girls in fairly conservative upstate NY

    "Symptoms may last for days or weeks and can include blindness, inability to speak, numbness or other neurologic problems."

    Any guesses on what might have set off the hysteria.....

    [​IMG]
  17. billypilgrim37

    billypilgrim37 Unstuck in Time

    Joined:
    Apr 21, 2007
    Messages:
    2,400
    Status:
    Attending Physician
    Physician Faculty SDN 7+ Year Member
    Whether there's any truth to it or not, some of the commenters on those websites report they are from nearby that area (apparently it has been in the local news for a while) and that the girls were bullies who were actually targeting a girl with Tourette's. Sounds a little fishy, but honestly, sounds less fishy than the other theories.

    How long will it take some nutjob off the forum street to find it's way on this forum and tell me how evil I am for questioning the suffering of these poor little victims of medical hegemony?

    To said nutjob who finds their way onto the forum: To be clear, I'm railing against the idiots in the comments sections who think that we are all conspiring with drug companies to suppress The Truth about a myriad of diseases that have not found their way into the mainstream. I haven't examined the girls. The reports are very suggestive of conversion disorder, but what do I know? I'm only a person with a high IQ who has devoted my entire professional life to becoming a specialist in mental health. I'm sure your hours of googling with that tinfoil cap on your head has made you much more qualified to discuss nuanced mental health issues than I am.

    Thank you. And I hope you don't get c.diff from the antibiotics you're taking for your chronic lyme disease.
  18. OldPsychDoc

    OldPsychDoc Senior Curmudgeon Moderator Emeritus SDN Advisor

    Joined:
    Dec 2, 2004
    Messages:
    4,606
    Location:
    Left of Center
    Status:
    Attending Physician
    Physician SDN 7+ Year Member
    You may as well just put this in your sig, Billy. :D
  19. Ibid

    Ibid

    Joined:
    Jun 21, 2010
    Messages:
    626
    SDN 2+ Year Member
    The psychological benefits of reading Chekov are well documented. I dread to think what irreparable damage you have done to yourself by reading facebook comments.

    I am guessing that it lies on a continuum between weak skunk and jacking up and sniffing glue.

    At least your faith has somewhere to dip to. All I get is confirmation now.
  20. surftheiop

    surftheiop

    Joined:
    Dec 4, 2008
    Messages:
    1,942
    SDN 2+ Year Member
    If you ever want something to keep you awake at night read the comments below any article related to health on a major news website. And if you just want your head to explode, read the comments on a politics related one.
  21. Ibid

    Ibid

    Joined:
    Jun 21, 2010
    Messages:
    626
    SDN 2+ Year Member
    Yep. This is your average contributor.
    [YOUTUBE]http://www.youtube.com/watch?v=miOWJ4rKb_g[/YOUTUBE]
  22. billypilgrim37

    billypilgrim37 Unstuck in Time

    Joined:
    Apr 21, 2007
    Messages:
    2,400
    Status:
    Attending Physician
    Physician Faculty SDN 7+ Year Member
    Nevermind the pain after I had to bleach my eyes out to try to remove the images from my brain...

    Now to figure out how to update my sig... ;)
  23. PETRAN

    PETRAN

    Joined:
    Dec 28, 2010
    Messages:
    187
    Status:
    Psychology Student
    SDN 2+ Year Member


    Your conversion theory is not in accordance to your high IQ. Here are some ingenious responses and theories of what might have really happened...




    "There are Solo Targeted American citizens who have come forward to proper authorities about similar symptoms...The militarization of Cognitive Neuroscience and Neurotechnologies is the culprit, being used in an experimental Offensive manner for the purpose of coercive forced cognitive, motor, and central nervous system modifications and alterations..."


    "Poison in food. Do you eat on the tray? Rat poison in the back of schools to keep the rodents dead. Some nutty person could be putting it in food indiscriminately..."




    "They've seen the devil, I tell ye..."
  24. nancysinatra

    nancysinatra

    Joined:
    Sep 27, 2007
    Messages:
    1,209
    Location:
    Still walkin'
    Status:
    Resident [Any Field]
    SDN 5+ Year Member
    Ugh, why did you guys have to draw my attention to this story? I just spent a 1/2 hour of my life reading those comments which I could have spent looking for names of my high school classmates in the "misdemeanors" section of my hometown newspaper.

    I think it's the militarized industrialized mold in that school, BTW.
  25. Apollyon

    Apollyon Screw the GST Lifetime Donor

    Joined:
    Nov 24, 2002
    Messages:
    16,350
    Location:
    SCREW IT!
    Physician SDN 10+ Year Member
    Being from the area (and visiting here right now), I would not put the western NY area on even the top 20 most conservative areas in the US.

    Incidentally, I met Laszlo Mechtler almost 20 years ago. He's the neurologist that made the conversion dx on these girls.
  26. Ibid

    Ibid

    Joined:
    Jun 21, 2010
    Messages:
    626
    SDN 2+ Year Member
    The thing is that truth is often stranger than fiction. (obv not implying anything, just saying its not a surprise people come up with what seem like odd theories when something very much like them has been true in the past)


    http://en.wikipedia.org/wiki/Project_MKULTRA

    http://en.wikipedia.org/wiki/Donald_Ewen_Cameron

    http://www.guardian.co.uk/world/2011/sep/28/aid-agency-pakistan-cia-vaccination
  27. surftheiop

    surftheiop

    Joined:
    Dec 4, 2008
    Messages:
    1,942
    SDN 2+ Year Member

    I hesitated to put the conservative in there, but figured it made for a better effect. Maybe all parts of NY (except NYC), seem conservative to me after spending 4 years in Ithaca :eek:
  28. nancysinatra

    nancysinatra

    Joined:
    Sep 27, 2007
    Messages:
    1,209
    Location:
    Still walkin'
    Status:
    Resident [Any Field]
    SDN 5+ Year Member
    It depends where you're coming from. Coming from a progressive state in the midwest, I have found NYC to be "conservative," i.e. money tends to stay in the hands of those who have it. And having lived in Europe all of the US seems "conservative."
  29. wholeheartedly

    wholeheartedly Moderator

    Joined:
    Aug 8, 2009
    Messages:
    2,404
    Location:
    Beyond the Wall
    Status:
    Pre-Medical
    SDN 5+ Year Member
    Thanks for posting, studying public health that last one struck me as especially nice :(
  30. OldPsychDoc

    OldPsychDoc Senior Curmudgeon Moderator Emeritus SDN Advisor

    Joined:
    Dec 2, 2004
    Messages:
    4,606
    Location:
    Left of Center
    Status:
    Attending Physician
    Physician SDN 7+ Year Member
  31. zwitterion34

    zwitterion34 .4520000000000000k Member

    Joined:
    Aug 11, 2011
    Messages:
    802
    Status:
    Medical Student
    NCPA Kappa Psi hSDN Member hSDN Alumni SDN 2+ Year Member
    Is this just me or does it remind anyone of the Crucible? :cool:
  32. billypilgrim37

    billypilgrim37 Unstuck in Time

    Joined:
    Apr 21, 2007
    Messages:
    2,400
    Status:
    Attending Physician
    Physician Faculty SDN 7+ Year Member
    That's been mentioned some in the media as well. Similar, though the Goodies of the crucible were malingering vs. factitious disorder, while from the history presented in the media, sounds like factitious vs conversion would be most consistent with the media story. So really similar, but different enough to be an interesting difference. And we only get the girls' story en masse, not with individuals, and there's a good chance there's some variation among the girls as well.

Share This Page


About the ads