ILLNESS BEHAVIOR IN THE ACUTE-PHASE OF MOTOR DISABILITY IN NEUROLOGICAL DISEASE AND IN CONVERSION DISORDER - A COMPARATIVE-STUDY

Sixty patients with a sudden onset of motor disability were assessed f or illness behavior and depression. In 30 of the patients, etiology wa s attributed to a definite structural lesion. The remaining 30 patient s were diagnosed as having conversion disorder. The Illness Behaviour Questionnaire (IBQ) and the Hamilton Rating Depression Scale (HRDS) we re used as instruments for assessment. The mean HRDS score was signifi cantly higher in the conversion group, indicating a higher degree of a ffective disease in these patients. According to the results of the IB Q, the patients with conversion disorder showed a higher degree of irr itability, disease conviction, and phobic preoccupation, and also, to a greater extent, rejected psychological explanations for their sympto ms. Denial was high in both patient groups, coexisting with affective symptoms in the conversion patients but not in the neurological patien ts. Although valuable information could be extracted from the IBQ, it was not found to be a reliable instrument for distinguishing between p sychogenic and organic causes of motor disability. (C) 1998 Elsevier S cience Inc.