전환장애의 치료와 관리

Abstract

Conversion disorder is a psychologically produced aIteration or loss of physicaIfunctioning suggestive of a physical disorder. Conversion symptoms are oftensuperimposed on organic disease and can be overlooked. PsychologicaI techniques arecentraI to the management include the following: avoiding confrontation with the patients; avoiding reinforcement or triviaIizing the symptoms; reviewing results of tests andexams and creating an expectation of recovery; educating the patient before a treatmentis begun; evaluating the patient's emotional adjustment and considering it at a treatment;using caution in labeling the condition; considering referral for psychotherapy;establishing particularly a treatment plan and making a definite treatment program;adjusting patient' s environment; letting participate a family at appropriate time;developing a reinforcement program for a treatment of chronic symptoms; deveIoping ahome program for outpatients. Use behavior therapy reinforcement may be helpful withmore chronic or resistant symptoms, especially when there is a history of vague orexcessive somatic complaints or significant secondary gain.