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Table of Contents
Vol. 71, No. 2, 2002
Issue release date: March–April 2002
Psychother Psychosom 2002;71:66–76

A Randomised Controlled Clinical Trial on the Additional Effect of Hypnosis in a Comprehensive Treatment Programme for In-Patients with Conversion Disorder of the Motor Type

Moene F.C. · Spinhoven P. · Hoogduin K.A.L. · van Dyck R.
aTreatment Unit for Conversion Disorders, ‘De Grote Rivieren’, Organisation for Mental Health, Psychiatric Centre Albert Schweitzerplaats, Dordrecht, bDepartment of Clinical Psychology, Leiden University, Leiden, cDepartment of Clinical Psychology and Personality, Nijmegen University, Nijmegen, dDepartment of Psychiatry, Vrije Universiteit, Amsterdam, The Netherlands

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Background: The primary aim of this study was threefold: (1) to examine the additional effects of hypnosis aimed at symptom reduction, using symptom-oriented and expression- and insight-oriented techniques in a comprehensive clinical treatment programme for in-patients with a persistent conversion disorder of the motor type; (2) to assess whether the level of hypnotisability was predictive of treatment outcome, and (3) to explore the efficacy of the total clinical treatment programme. Methods: The study population consisted of 45 in-patients between 18 and 65 years of age meeting the DSM-III-R criteria for conversion disorder of the motor type or somatisation disorder with motor conversion symptoms. A randomised controlled clinical trial was undertaken. The primary outcome measures were the Video Rating Scale for Motor Conversion Symptoms, the D(isabilities) code items from the International Classification of Impairments, Disabilities and Handicaps and the Symptom Checklist-90. Measures of the credibility of treatment and patient expectations of treatment outcome were used as manipulation checks. Hypnotisability was measured using the Stanford Hypnotic Clinical Scale. Results: Significant treatment results for all outcome measures were found for the total sample. These effects proved to be clinically significant. The use of hypnosis had no additional effect on treatment outcome. Hypnotisability was not predictive of treatment outcome. Conclusion: A comprehensive treatment programme, either with or without hypnosis, can be worthwhile for patients with long-standing conversion symptoms.

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  1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, American Psychiatric Association, 1994.
  2. Folks DG, Ford CV, Regan WM: Conversion symptoms in a general hospital. Psychosomatics 1984;4:285–295.
  3. Cloninger CR, Martin RL, Guze SB, Clayton PJ: A prospective follow-up and family study of somatization in men and women. Am J Psychiatry 1986;143:873–878.

    External Resources

  4. Binzer M, Andersen P, Kullgren G: Clinical characteristics of patients with motor disability due to conversion disorder: A prospective control group study. J Neurol Neurosurg Psychiatry 1997;63:83–88.
  5. Kent DA, Tomasson K, Coryell W: Course and outcome of conversion and somatization disorders. A four-year follow-up. Psychosomatics 1995;36:138–144.
  6. Hafeiz HB: Hysterical conversion: A prognostic study. Br J Psychiatry 1980;136:548–551.
  7. Baker JH, Silver JR: Hysterical paraplegia. J Neurol Neurosurg Psychiatry 1987;50:375–382.

    External Resources

  8. Fishbain DA, Goldberg M, Khalil TM, Asfour SS, Abdel-Moty E, Meagher BR, Santana R, Rosmoff RS, Rosmoff HL: The utility of electromyographic biofeedback in the treatment of conversion paralysis. Am J Psychiatry 1988;12:1572–1575.
  9. Toone BK: Disorders of hysterical conversion; in Bass C (ed): Somatization: Physical Signs and Psychological Illness. Oxford, Blackwell Scientific, 1990, pp 207–234.
  10. Mace CJ, Trimble MR: Ten-year prognosis of conversion disorder. Br J Psychiatry 1996;169:282–288.
  11. Crimlisk HL, Bhatia K, Cope H, David A, Marsden CD, Ron MA: Slater revisited: 6-year follow-up study of patients with medically unexplained motor symptoms. BMJ 1998;316:582–586.
  12. Ford CV, Folks DG: Conversion disorders: An overview. Psychosomatics 1985;26:371–374, 380–383.
  13. Moene FC, Hoogduin KA, van Dyck R: The inpatient treatment of patients suffering from (motor) conversion symptoms: A description of eight cases. Int J Clin Exp Hypn 1998;46:171–190.
  14. Janet P: The Major Symptoms of Hysteria. London, Macmillan, 1907. Reprint: New York, Hafner, 1965.
  15. Hurst AH (ed): Medical Diseases of War, ed 3. London, Edward Arnold & Co., 1943, pp 1–115.
  16. Wilkins LG, Field PB: Helpless under attack: Hypnotic abreaction in hysterical loss of vision. Am J Clin Hypn 1968;4:271–275.
  17. Patterson RB: Hypnotherapy of hysterical monocular blindness: A case report. Am J Clin Hypn 1980;23:119–121.

    External Resources

  18. McCue EC, McCue PA: Hypnosis in the elucidation of hysterical aphonia: A case report. Am J Clin Hypn 1988;36:178–182.
  19. Hoogduin CAL, van Dyck R: On the hypnotherapeutic treatment of motor conversion disorders. Swed J Hypn Psychosom Med 1990;4:214–220.
  20. Scallet A, Cloninger CR, Othmer E: The management of chronic hysteria: A review and double-blind trial of electrosleep and other relaxation methods. Dis Nerv Syst 1976;37:347–353.

    External Resources

  21. Kop PFM, Heijden van der HP, Hoogduin CAL, Schaap CPDR: Operant procedures applied to a conversion disorder. Clin Psychol Psychother 1995;1:59–66.
  22. Turner SM, Hersen M: Instructions and reinforcement in modification of a case of astasia-abasia. Psychol Rep 1975;36:607–612.

    External Resources

  23. Frank JD: Therapeutic components of all psychotherapies. J Nerv Ment Dis 1974;159:325–342.

    External Resources

  24. Krull F, Schifferdecker M: Inpatient treatment of conversion disorder: A clinical investigation of outcome. Psychother Psychosom 1990;53:161–165.

    External Resources

  25. Montgomery JM, Espie CA: Behavioral management of hysterical pseudoseizures. J Behav Psychother 1986;14:334–340.
  26. Munford PR, Paz G: Differential attention in the treatment of astasia-abasia. J Behav Ther Exp Psychiatry 1978;9:369–371.

    External Resources

  27. Klonoff EA, Moore DJ: ‘Conversion reactions’ in adolescents: A biofeedback-based operant approach. J Behav Ther Exp Psychiatry 1986;17:179–184.
  28. Orne MT: On the construct of hypnosis: How its definition affects research and clinical application; in Burrows GD, Dennerstein L (eds): Handbook of Hypnosis and Psychosomatic Medicine. Amsterdam, Elsevier, 1980, pp 29–49.
  29. Bliss EL: Hysteria and hypnosis. J Nerv Ment Dis 1984;172:203–206.
  30. Spinhoven P: The clinical relevance of hypnotic susceptibility; in Fass ML, Brown D (eds): Creative Mastery in Hypnosis and Hypnoanalysis. Hillsdale, Lawrence Erlbaum Associates, 1990, pp 107–124.
  31. Tausk F, Whitmore SE: A pilot study of hypnosis in the treatment of patients with psoriasis. Psychother Psychosom 1999;68:221–225.
  32. van Dyck R: Psychotherapy, Placebo and Suggestions; thesis, Leiden, 1986.
  33. Montgomery GH, DuHamel KN, Redd WH: A meta-analysis of hypnotically induced analgesia: How effective is hypnosis? Int J Clin Exp Hypn 2000;48:138–153.
  34. Pinnell CM, Covino NA: Empirical findings on the use of hypnosis in medicine: A critical review. Int J Clin Exp Hypn 2000;48:170–194.
  35. Cardeña E: Hypnosis in the treatment of trauma: A promising, but not fully supported, efficacious intervention. Int J Clin Exp Hypn 2000;48:225–239.
  36. Lynn SJ, Kirsch I, Barabasz A, Cardeña E, Patterson D: Hypnosis as an empirically supported clinical intervention: The state of the evidence and a look to the future. Int J Clin Exp Hypn 2000;48:239–259.
  37. Moene FC, Spinhoven P, Hoogduin CAL, van Dyck R: A randomized controlled clinical trial of a hypnosis-based treatment for patients with conversion disorder, motor type. Int J Clin Exp Hypn, in press.
  38. Moene FC, Landberg EH, Hoogduin KA, Spinhoven P, Hertzberger LI, Kleyweg RP, Weeda J: Organic syndromes diagnosed as conversion disorder: Identification and frequency in a study of 85 patients. J Psychosom Res 2000;49:7–12.

    External Resources

  39. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 3, revised. Washington, American Psychiatric Association, 1987.
  40. Moene FC: A Semi Structured Intake Interview. Dordrecht, Albert Schweitzerplaats Psychiatric Center, 1991.
  41. Moene FC: Patient Information about the Study. Dordrecht, Albert Schweitzerplaats Psychiatric Center, 1991.
  42. Moene FC: Therapist Treatment Protocol. Dordrecht, Albert Schweizterplaats Psychiatric Center, 1991.
  43. van Dyck R, Hoogduin K: Hypnosis and conversion disorders. Am J Psychother 1989;43:480–493.

    External Resources

  44. Hoogduin K, Akkermans M, Oudshoorn DN, Reinders M: Hypnotherapy and contractures of the hand. Am J Clin Hypn 1993;36:106–112.
  45. Moene FC: Therapist Information about the Study and the Treatment. Dordrecht, Albert Schweitzerplaats Psychiatric Center, 1991.
  46. Moene FC: Physical Rehabilitation Program. Dordrecht, Albert Schweitzerplaats Psychiatric Center, 1991.
  47. Moene FC, Sandyck P, Spinhoven P, Hoogduin CAL, Van Dijk F, Redert JFM: Assessment of conversion disorder, motor type: Development, reliability and validity of the VRMC, a video rating scale for motor conversion symptoms. Psychol Assess, in press.
  48. Jiwa-Boerrichter H, van Engelen HGM, Lankhorst GJ: Application of the ICIDH in rehabilitation medicine. Int Disabil Stud 1990;12:17–19.
  49. Arrindell WA, Ettema JHM: Dimensional structure, reliability and validity of the Dutch version of the Symptom Checklist (SCL-90); data based on a phobic and a normal population. Ned Tijdschr Psychol 1981;36:77–108.
  50. Oyen F, Spinhoven P: The Dutch version of the SHCS. Tijdschr Dir Ther 1983;3:155–172.
  51. Moene FC: Credibility of Treatment Conditions, Patient Expectations of Treatment Outcome and Duration of Treatment. Dordrecht, Albert Schweitzerplaats Psychiatric Center, 1991.
  52. Couprie W, Wijdicks EFM, Rooijmans HGM, van Gijn J: Outcome in conversion disorder: A follow-up study. J Neurol Neurosurg Psychiatry 1995;58:750–752.
  53. Kroenke K, Swindle R: Cognitive-behavioral therapy for somatization and symptom syndromes: A critical review of controlled clinical trials. Psychother Psychosom 2000;69:205–215.
  54. Moene FC, Spinhoven P, Hoogduin CAL, Sandijck P, Roelofs K: Hypnotizability, dissociation and trauma in patients with a conversion disorder: An exploratory study. Clin Psychol Psychother, in press.
  55. Chambless DL, Hollon SD: Defining empirically supported therapies. J Consult Clin Psychol 1998;66:7–18.
  56. Bryant RA, McConkey KM: Hypnotic blindness, awareness, and attribution. J Abnorm Psychol 1989;98:443–447.
  57. Frauman DC, Lynn SJ, Brentar JP: Prevention and therapeutic management of ‘negative effects’ in hypnotherapy; in Rhue J, Lynn S, Kirsch I (eds): Handbook of Clinical Hypnosis. Washington, American Psychological Association, 1993, pp 95–120.
  58. Kleinhauz M, Eli I: Potential deleterious effects of hypnosis in the clinical setting. Am J Clin Hypn 1987;29:155–159.

    External Resources

  59. Moene FC, Hoogduin KA: The creative use of unexpected responses in the hypnotherapy of patients with conversion disorders. Int J Clin Exp Hypn 1999;47:209–227.

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