• Ruaidhri McCormack, John Moriarty, John D Mellers, Paul Shotbolt, Rosa Pastena, Nadine Landes, Laura Goldstein, Simon Fleminger, and Anthony S David.
• National Institute for Health Research (NIHR) Biomedical Research Centre, South London & Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, UK Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King's College London, London, UK.
• J. Neurol. Neurosurg. Psychiatr. 2014 Aug 1; 85 (8): 895-900.

BackgroundGold standard protocols have yet to be established for the treatment of motor conversion disorder (MCD). There is limited evidence to support inpatient, multidisciplinary intervention in chronic, severe cases.AimsTo evaluate the characteristics and outcomes of MCD patients admitted to a specialist neuropsychiatric inpatient unit.MethodsAll patients admitted to the Lishman Unit (years 2007-2011) with a diagnosis of MCD were included. Data relevant to characteristics and status with regard to mobility, activities of daily living (ADLs) and Modified Rankin Scale (MRS) score at admission and discharge were extracted.ResultsThirty-three cases (78.8% female) were included; the median duration of illness was 48 months. In comparison with brain injury patients admitted to the same unit, more cases had histories of childhood sexual abuse (36.4%, n=12), premorbid non-dissociative mental illness (81.1%, n=27) and employment as a healthcare/social-care worker (45.5%, n=15). Cases showed significant improvements in MRS scores (p<0.001), mobility (p<0.001) and ADL (p=0.002) following inpatient treatment.ConclusionsPatients with severe, long-standing MCD can achieve significant improvements in functioning after admission to a neuropsychiatry unit.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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