ILLNESS PERCEPTION AND TREATMENT EXPECTATION IN PATIENTS WITH FUNCTIONAL NEUROLOGICAL SYMPTOM DISORDER AT LAHORE, PAKISTAN

Keywords: Illness perception, treatment expectation, FNSD

Abstract

OBJECTIVE

To explore the perceived illness and treatment expectations of patients with Functional Neurological Symptom Disorder.

DESIGN OF STUDY

It is a Descriptive Research Design 

PLACE AND DURATION

The study was executed at Department of Psychiatry of government and private teaching hospitals of Lahore, Pakistan over a period of 12 months, from Jan 2023 to Dec 2023.

METHOD

A total of 100 adult participants were recruited as per criteria. Demographic Information Questionnaire and Short Explanatory Model Interview (SEMI) were employed and the qualitative data generated from SEMI was converted to numerical codes and discrete categories by the method of stepwise reduction. The descriptive frequencies were then presented in the tabular format.

RESULTS

Majority of the participants were female, educated, students and housewives, with 1 – 6 months duration of the illness, mixed symptoms presentation, pseudo seizures and motor symptoms. The main reasons of onset of illness was mentioned as marriage related factors and familial and social factors and majority participants believe that magic can affect others. The intensity of the symptoms were perceived as ‘extreme intense’ associated with the fear about the worsening of symptoms and serious discomfort. The main difficulties due to illness was reported to be lack of interest in daily activities, and increase in problem in relationships. The patients expect proper treatment and prescription of medicines which was followed by responses that they will learn the diagnosis and will receive advice from doctors regarding their illness.

CONCLUSION

The patient’s perception towards their illness was serious and concerned and their expectations was receiving proper treatment, medications and learning the disorder and doctor’s advice.

Downloads

Download data is not yet available.

Author Biographies

Sara Latif, Centre for Clinical Psychology, Punjab University, Lahore, Pakistan

 

Lecturer, Higher Education Department

Aisha Sitwat, Centre for Clinical Psychology, University of the Punjab, Lahore, Pakistan

Assistant Professor

References

1. Stone J, Hallett M, Carson A, Bergen D, Shakir R. Functional disorders in the Neurology section of ICD-11: A landmark opportunity. Neurology. 2014 Dec 9;83(24):2299-301. doi: 10.1212/WNL.0000000000001063.
2. Bokharey IZ, Fahim U, Tahir K. Family conflicts are bitter splits that hurt: a qualitative inquiry toward understanding the impact of family issues in functional neurological symptom disorder. Frontiers in Psychology. 2021;12:652917. doi: 10.3389/fpsyg.2021.652917
3. Li X, Wang X, Zhou G. Heterogeneity of emotional distress in pregnancy during COVID-19 pandemic: a latent profile analysis. J Reprod Infant Psychol. 2023: p. 1-12.
4. Khan AM, Taj R, Khan AY, Naveed A, Wali A. Clinical characteristics and demographic correlates of conversion disorder in Pakistani Patients: A study from a Psychiatry Unit in PIMS Islamabad. Journal of Bashir Institute of Health Sciences. 2023 Jun 25;4(1):10-9.
5. Khan S, Ladha A, Khan SK, Khan SF, Malik AA, Memon Z, Nabi SG, Adnan HY, and Naqvi HA. Presentation and features of conversion disorder at a tertiary care hospital in karachi. Pak J Neurol Sci. 2006; 1(3):128-31
6. Bokharey I, Rahman NK. Symptom Checklist Conversion Disorder. Pakistan Journal of Clinical Psychology. 2013;12, 1.
7. Khan F, Bhimani M, Arfeen T, & Zaman M. Conversion disorder in young people of Karachi: a 20 years retrospective review. Isra Medical Journal. 2014; 6 (4). 285 – 288.
8. Munawar K, Choudhry FR. Exploring stress coping strategies of frontline emergency health workers dealing Covid-19 in Pakistan: A qualitative inquiry. American Journal of Infection and Control. 2021; 49(3), 286-292. doi: 10.1016/j.ajic.2020.06.214.
9. Choudhry FR, Mani V, Ming LC, Khan TM. Beliefs and perception about mental health issues: a meta-synthesis. Neuropsychiatr Dis Treat. 2016 Oct 31;12:2807-2818. doi: 10.2147/NDT.S111543.
10. Mirza I, Hassan R, Chaudhary H, Jenkins R. Eliciting explanatory models of common mental disorders using the Short Explanatory Model Interview (SEMI) Urdu adaptation--a pilot study. J Pak Med Assoc. 2006 Oct;56(10):461-3.
11. Lakhani S, Sharma V, Desai NG. Qualitative content analysis of cultural formulations of clients suffering from conversion disorder in North India. Indian Journal of Psychiatry. 2022 Jan 1;64(1):73-9.
12. Lloyd KR, Jacob KS, Patel V, Louis LS, Bhugra D, Mann AH. The development of the Short Explanatory Model Interview (SEMI) and its use among primary-care attenders with common mental disorders. Psychological medicine. 2000; 28(5), 1231-1237.
13. Stone J, Smyth R, Carson A, Warlow C. La belle indifférence in conversion symptoms and hysteria: Systematic review. British Journal of Psychiatry. 2006;188(3):204-209. doi:10.1192/bjp.188.3.204
14. Desai G, Chaturvedi SK. Idioms of distress. J Neurosci Rural Pract. 2017; 8 Suppl 1 S94–7
15. Kanaan R, Armstrong D, Wessely S Limits to truth telling: Neurologists' communication in conversion disorder. Patient Educ Couns. 2009; 77: 296–301
16. Hall-Patch L, Brown R, House A, Howlett S, Kemp S, Lawton G, et al Acceptability and effectiveness of a strategy for the communication of the diagnosis of psychogenic nonepileptic seizures. Epilepsia. 2010; 51: 70–8
17. Hashmi A, Mazhar N, Malik A. The Burden on Her Soul: Conversion Disorder in Developing Countries. Annals of King Edward Medical University, Lahore. 2012; 18. 9-11.
18. Naeem F, Ayub M, Kingdon D, Gobbi M. Views of Depressed Patients in Pakistan Concerning Their Illness, Its Causes, and Treatments. Qualitative Health Research. 2012;22(8):1083-1093. doi:10.1177/1049732312450212
19. Binzer M, Anderson PM, Kulllgren 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.
20. Syed EU, Atiq R, Effendi S, Mehmud S. Conversion disorder: Difficulties in diagnosing using DSM-IV/ ICD-10. JPMA 2001; 51(4):143-5.
21. Khan MN, Ahmad S, Arshad N, Ullah N, Maqsood N. Anxiety and depressive symptoms in patients with conversion disorder. J Coll Physicians Surg Pak 2005; 15(8):489-92.
22. Teasell RW, Shapiro AP. Strategic-behavioral intervention in the treatment of chronic nonorganic motor disorders. Am J Phys Med Rehabil 1994; 73:44-50.
23. Chaudhry HR, Arshad N, Niaz S, Cheema FA, Iqbal MM, Mufti KA. Fifteen-year follow-up of conversion disorder. International Psychiatry 2005; 2(10):17-9.
24. Soffer J, Alper KR, Basch SA. Psychodynamic understanding of conversion nonepileptic seizures in a young woman with acquired blindness. CNS Spectrum 2008; 13(7): 575-84
25. Sumathipala A, Siribaddana S, Hewege S, Sumathipala K, Prince M, Mann A Understanding the explanatory model of the patient on their medically unexplained symptoms and its implication on treatment development research:A Sri Lanka Study BMC Psychiatry. 2008; 8: 54
26. Nambi SK, Prasad J, Singh D, Abraham V, Kuruvilla A, Jacob KS. Explanatory models and common mental disorders among patients with unexplained somatic symptoms attending a primary care facility in Tamil Nadu. National Medical Journal of India. 2002 Jan 1;15(6):331-5.
27. Akhtar J, Haq M, Awan NR, Irfan M, Shafiullah, Asadullah, Farooq S. Beliefs and attitudes of family members towards patients suffering from conversion disorder. Journal of Pakistan Psychiatric Society. 2013; 10 (1): 21-24.
Published
2024-09-28
How to Cite
1.
Latif S, Sitwat A. ILLNESS PERCEPTION AND TREATMENT EXPECTATION IN PATIENTS WITH FUNCTIONAL NEUROLOGICAL SYMPTOM DISORDER AT LAHORE, PAKISTAN. J Pak Psychiatr Soc [Internet]. 2024Sep.28 [cited 2024Dec.21];21(03). Available from: https://jpps.pk/index.php/journal/article/view/362