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Intervenciones psicosociales para el trastorno de conversión

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Referencias

References to studies included in this review

Ir a:

Ataoglu 2003 {published data only}

Ataoglu A, Ozcetin A, Icmeli C, Ozbulut O. Paradoxical therapy in conversion reaction. Journal of Korean Medical Science 2003;18(4):581‐4.

Moene 2002 {published data only}

Moene FC, Spinhoven P, Hoogduin KA, Van Dyck R. 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.. Psychotherapy and Psychosomatics 2002;71(2):66‐76.

Moene 2003 {published data only}

Moene FC, Spinhoven P, Hoogduin KA, van Dyck R. A randomized controlled clinical trial of a hypnosis‐based treatment for patients with conversion disorder, motor type.. International Journal of Clinical and Experimental Hypnosis 2003;51:29‐50.

References to studies excluded from this review

Ir a:

Behr 1996 {published data only}

Behr J. The role of physiotherapy in the recovery of patients with conversion disorder. Physiotherapy Canada 1996;48(3):197‐202.

Bellamy 1989 {published data only}

Bellamy RF, McCaughey BG, Fragala MR. Slight hysteria. Military Medicine 1989;154(2):94‐7.

Berkwitz 1952 {published data only}

Berkwitz NJ. Outpatient treatment with faradic (non‐convulsive electric) stimulation. Confinia Neurologica 1952;12:362‐3.

Bhattacharyya 1971 {published data only}

Bhattacharyya DD, Singh R. Behavior therapy of hysterical fits. American Journal of Psychiatry 1971;128(5):602‐6.

Binzer 1997 {published data only}

Binzer M, Andesen PM, Kullgren G. Clinical characteristics of patients with motor disability due to conversion disorder: a prospective control group study.. Journal of Neurology, Neurosurgery and Psychiatry 1997;63:83‐8.

Cardenas 1986 {published data only}

Cardenas DD, Larson J, Egan KJ. Hysterical paralysis in the upper extremity of chronic pain patients.. Archives of Physical Medicine & Rehabilitation. 1986;67(3):190‐3.

Carter 1949 {published data only}

Carter AB. The prognosis of certain hysterical symptoms. British Medical Journal 1949;1:1076‐8.

Casacchia 1989 {published data only}

Casacchia M, Farolfi A, Priore P, Magni G, Stratta P, Cesana B, et al. A double‐blind, placebo‐controlled study of alpidem, a novel anxiolytic of imidazopyridine structure, in chronically anxious patients. Acta Psychiatrica Scandinavica 1989;80(2):137‐41.

Delargy 1986 {published data only}

Delargy MA, Peatfield RC, Burt AA. Successful rehabilitation in conversion paralysis. BMJ 1986;292:1730‐1.

Dickes 1974 {published data only}

Dickes RA. Brief therapy of conversion reactions: an in‐hospital technique. American Journal of Psychiatry 1974;131:584‐6.

Ellason 1997 {published data only}

Ellason JW, Ross CA. Two‐year follow‐up of inpatients with dissociative disorder. American Journal of Psychiatry 1997;154:832‐9.

Fackler 1997 {published data only}

Fackler SM, Anfinson TJ, Rand JA. Serial sodium amytal interviews in the clinical setting. Psychosomatics 1997;38:558‐64.

Geetha 1980 {published data only}

Geetha PR, Channabasavanna SM, Bhatti RS. The study of efficacy of family ward treatment in hysteria in comparison with the open ward and the outpatient treatment. Indian Journal of Psychiatry 1980;22(4):317‐21.

Gooch 1997 {published data only}

Gooch JL, Wolcott R, Speed J. Behavioral management of conversion disorder in children. Archives of Physical Medicine & Rehabilitation 1997;78(3):264‐8.

Grattan‐Smith 1988 {published data only}

Grattan‐Smith P, Fairley M, Procopis P. Clinical features of conversion disorder. Archives of Disease in Childhood 1988;63(4):408‐14.

Guida 1954 {published data only}

Guida A. Observations on scopochloralose. Neurone 1954;2:133‐61.

Hafeiz 1980 {published data only}

Hafeiz HB. Hysterical conversion: a prognostic study. British Journal of Psychiatry 1980;136:548‐51.

Halpern 1944 {published data only}

Halpern HJ. Hysterical amblyopia. Bulletin. United States Army Medical Department. 1944;72:84‐7.

Hoogduin 1993 {published data only}

Hoogduin K, Akkermans M, Oudshoorn D, Reinders M. Hypnotherapy and contractures of the hand. American Journal of Clinical Hypnosis 1993;36(2):106‐12.

Kotsopoulos 1986 {published data only}

Kotsopoulos S, Snow B. Conversion disorders in children: A study of clinical outcome. Psychiatric Journal of the University of Ottawa 1986;11(3):134‐9.

Koufman 1982 {published data only}

Koufman JA, Blalock PD. Classification and approach to patients with functional voice disorders. Annals of Otology, Rhinology & Laryngology 1982;91:372‐7.

Krull 1990 {published data only}

Krull F, Schifferdecker M. Inpatient treatment of conversion disorder: a clinical investigation of outcome. Psychotherapy and Psychosomatics 1990;53:161‐5.

Kupper 1947 {published data only}

Kupper WH. Observations on the use of a phonograph record of battle sounds employed in conjunction with pentothal in the treatment of 14 cases of severe conversion hysteria caused by combat. Journal of Nervous and Mental Disease 1947;105:56‐60.

Lehmkuhl 1989 {published data only}

Lehmkuhl G, Blanz B, Lehmkuhl U, Braun‐Scharm H. Conversion disorder (DSM‐III 300.11): symptomatology and course in childhood and adolescence. European Archives of Psychiatry and Neurological Sciences 1989;238:155‐60.

Leslie 1988 {published data only}

Leslie SA. Diagnosis and treatment of hysterical conversion reactions. Archives of Disease in Childhood 1988;63:506‐11.

Pu 1986 {published data only}

Pu T, Mohamed E, Iman K, El‐Roey A. One hundred cases of hysteria in Eastern Libya: A socio‐demographic study. British Journal of Psychiatry 1986;148:606‐9.

Puhakka 1988 {published data only}

Puhakka HJ, Kirveskari P. Globus hystericus: globus syndrome?. Journal of Laryngology and Otology 1988;102(3):231‐4.

Ramani 1982 {published data only}

Ramani V, Gumnit RJ. Management of hysterical seizures in epileptic patients. Archives of Neurology 1982;39:78‐81.

Rampello 1996 {published data only}

Rampello L, Raffaele R, Nicoletti G, Le Pira F, Malaguarnera M, Drago F. Hysterical neurosis of the conversion type: therapeutic activity of neuroleptics with different hyperprolactinemic potency. Neuropsychobiology 1996;33:186‐8.

Rangaswami 1985 {published data only}

Rangaswami K. Treatment of hysterical conditions by avoidance conditioning. Dayalbagh Educational Institute Research Journal of Education 1985;3:53‐6.

Russell 1950 {published data only}

Russell RJ. Symptomatic treatment of hysteria with intensified electroconvulsant therapy. Lancet 1950;258:135‐6.

Scallet 1976 {published data only}

Scallet A, Cloninger CR, Othmer E. The management of chronic hysteria: a review and double‐blind trial of electrosleep and other relaxation methods. Diseases of the Nervous System 1976;37:347‐53.

Shapiro 1997 {published data only}

Shapiro AP, Teasell RW. Strategic‐behavioural intervention in the inpatient rehabilitation of non‐organic (factitious/conversion) motor disorders. Neurorehabilitation 1997;8:183‐92.

Shapiro 2004 {published data only}

Shapiro AP, Teasell W. Behavioural interventions in the rehabilitation of acute v chronic non‐organic ( conversion/ factitious) motor disorders. British Journal of Psychiatry 2004;185:140‐6.

Speed 1996 {published data only}

Speed J. Behavioral management of conversion disorder: retrospective study. Archives of Physical Medicine and Rehabilitation 1996;77:147‐54.

Suzuki 1979 {published data only}

Suzuki J, Yamauchi Y, Yamamoto H, Komuro U. Fasting therapy for psychosomatic disorders in Japan. Psychotherapy and Psychosomatics 1979;31:307‐14.

Turgay 1990 {published data only}

Turgay A. Treatment outcome for children and adolescents with conversion disorder. Canadian Journal of Psychiatry 1990;35:585‐9.

Watanabe 1998 {published data only}

Watanabe TK, O'Dell MW, Togliatti TJ. Diagnosis and rehabilitation strategies for patients with hysterical hemiparesis: A report of four cases. Archives of Physical Medicine & Rehabilitation 1998;79:709‐14.

White 1988 {published data only}

White A, Corbin D, Coope B. The use of thiopentone in the treatment of non‐organic locomotor disorders. Journal of Psychosomatic Research 1988;32:249‐53.

Williams 1979 {published data only}

Williams DT, Gold AP, Shrout P, et al. The impact of psychiatric intervention on patients with uncontrolled seizures. Journal of Nervous and Mental Disease 1979;167:626‐31.

Yaskin 1936 {published data only}

Yaskin JC. The psychoneuroses and neuroses. A review of 100 cases with special reference to treatment and end results. American Journal of Psychiatry 1936;93:107‐25.

Additional references

Ir a:

Akagi 2002

Akagi H, House AO. The epidemiology of hysteria: vanishingly rare or just vanishing?. Psychological Medicine 2002;32:191‐4.

Altman 1996

Altman DG, Bland JM. Detecting skewness from summary information.. BMJ 1996;313:1200.

APA 1994

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 4th edition.. Washington DC: American Psychiatric Association, 1994.

Arrindell 1981

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.

Bland 1997

Bland JM. Statistics notes. Trials randomised in clusters. BMJ 1997;315:600.

Burckhardt 1989

Burckhardt CS, Woods SL, Schultz AA, Ziebarth DM. Quality of life of adults with chronic illness: A psychometric study.. Research in Nursina and Health 1989;12:347‐54.

Clarke 2002

Clarke M, Oxman AD. Cochrane Collaboration Handbook.. Oxford: Update Software, 2002.

Davey Smith 1997

Davey Smith G, Egger M. Meta‐analyses of randomised controlled trials. Lancet 1997;350:1182.

DH 2001

Department of Health. Treatment Choice in Psychological Therapies and Counselling. Evidence based clinical practice guidelines. London: Department of Health., 2001.

Divine 1992

Divine GW, Brown JT, Frazier LM. The unit of analysis error in studies about physicians' patient care behavior. Journal of General Internal Medicine 1992;7:623‐9.

Egger 1997

Egger M, Davey‐Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple graphical test. BMJ 1997;315:629‐35.

Gulliford 1999

Gulliford MC. Components of variance and intraclass correlations for the design of community‐based surveys and intervention studies: data from the Health Survey for England 1994.. American Journal of Epidemiology 1999;149:876‐83.

Hamilton 1959

Hamilton MC. The assessment of anxiety states by rating. British Journal of Medical Psychology 1959;32:50‐5.

Jadad 1996

Jadad A. Assessing the quality of reports of randomized clinical trials: Is blinding necessary?. Controlled Clinical Trials 1996;17:1‐12.

Jenkinson 1996

Jenkinson C, Layte R, Wright L, Coulter A. The UK SF‐36: An Analysis and Interpretation Manual. Oxford: Health Services Research Unit, 1996.

Jiwa‐Boerrichter1990

Jiwa‐Boerrichter H, van Engelen HGM, Lankhorst GJ. Applicaton of the ICIDH in rehabilitation. International Disability Studies 1990;12:17‐9.

Ljungberg 1957

Ljungberg L. Hysteria: a clinical, prognostic and genetic study. Acta Psychiatrica et Neurologica Scandinavica 1957;32 Suppl 112:1‐162.

Mahoney 1965

Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Maryland State Medical Journal 1965;14:61‐65.

Marshall 2000

Marshall M. Unpublished rating scales: a major source of bias in randomised controlled trials of treatments for schizophrenia. British Journal of Psychiatry 2000;176:249‐52.

Moene in press

Moene FC, Sandyck P, Spinhoven P, Hoogduin CA, Van Dijk F, Redert JF. Assessment of conversion disorder motor type: Development , reliability and validity of the VRMC, a video rating scale for motor conversion symptoms.. Psychological Assessment in press.

Moher 2001

Moher D, Schulz KF, Altman D. The CONSORT statement: revised recommendations for improving the quality of reports of parallel‐group randomized trials. JAMA 2001;285:1987‐91.

Nabati 1998

Nabati L, Shea N, McBride L, Gavin C, Bauer MS. Adaptation of a simple patient satisfaction instrument to mental health: psychometric properties. Psychiatry Res 1998;77:51‐6.

Oyen 1983

Oyen F, Spinhoven P. The Dutch version of the SHCS. Tijdschr Dir Ther 1983;3:155‐72.

Ron 2001

Ron M. The prognosis of hysteria/ somatization disorder. Contemporary approaches to the study of hysteria. Oxford: Oxford University Press, 2001.

Schulz 1995

Schulz KF. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995;273:408‐12.

Silver 1996

Silver FW. Management of conversion disorder. American Journal of Physical Medicine and Rehabilitation 1996;75:134‐40.

Smeeth 1999

Smeeth L. Numbers needed to treat derived from meta‐analyses ‐sometimes informative, usually misleading. BMJ 1999;318:1548‐51.

Toone 1990

Toone BK. Disorders of hysterical conversion. In: Bass C editor(s). Somatization: Physical symptoms and psychological illness. Oxford: Blackwell Scientific Publications, 1990.

Veith 1970

Veith I. Hysteria : the history of a disease. Chicago, London: University of Chicago Press, 1970.

Ware 1988

Ware JE, Hays RD. Methods for measuring patient satisfaction with specific medical encounters. Med Care. 1988;26:393‐402.

WHO 1992

World Health Organization. The ICD‐10 classification of mental and behavioural disorders : clinical descriptions and diagnostic guidelines. Geneva: World Health Organization, 1992.

Wing 1994

Wing J. Measuring Mental Health Outcomes: a perspective from the Royal College of Psychiatrists. Outcomes in Clinical Practice.. London: BMJ Publishing, 1994.

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Ir a:

Ataoglu 2003

Methods

Allocation: randomised by computer
Blindness: Raters blind
Duration: 6 weeks

Participants

Diagnosis: Pseudoseizures using DSM IV criteria
N= 30
Age: mean = 27 years (range 18‐35 years).
Sex: 29f 1m
History: Admitted to the emergency unit with pseudoseizure. No information about previous seizures or comorbid psychiatric conditions. 8 people were illiterate (5 in PI group, 3 in diazepam group). Only 1 person had attended high school (diazepam group).
Setting: Department of psychiatry, state hospital, Kahramanmaras, Turkey.

Interventions

1. Inpatient treatment in psychiatric ward using PI. 2 sessions a day for 3 weeks. N=15
2. Outpatient treatment with diazepam (5‐15mg/day). Appointments at 10,20,30 and 45 days. N=15.

Outcomes

Mental state: HRSA at 6 weeks
Physical symptoms: any conversive attacks in last 2 weeks, at 6 weeks.
Leaving the study early

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment?

Unclear risk

B ‐ Unclear
Moene 2002

Methods

Allocation: block randomisation
Blindness: therapists and assessors blind
Duration: 8 months

Participants

Diagnosis: conversion disorder, motor type or somatization disorder with motor conversion symptoms according to DSMIIIR.
N= 45
Age: Mean 36.8 (sd 11.31, range 18‐56yr)
Sex: 34 f 11 m
History: Mean age of onset of symptoms = 32.6yr (sd 10.9yr, range 16‐54yr). Mean duration of symptoms =3.9 years (sd 4.5 months, range 2 months‐22 years). 18 had acute onset. 33 previous outpatient treatment and 18 inpatient treatment. 32 used medication. 37 used technical aids
Setting: Referred to outpatient psychiatric departments in Dordrecht and Delft, Netherlands.

Interventions

1. Inpatient treatment programme (groups, individual physiotherapy, exercise and bed rest) + hypnosis (therapy manual) introductory session and Ihr a week for 8 weeks. Also encouraged to practice self hypnosis for 1/2hr/ day with audiotape to help. N=26
2. Inpatient treatment programme (groups, individual physiotherapy, exercise and bed rest) + 1hr sessions for 8 weeks of encouragement to talk about experience and homework to write about sessions. N=23

Outcomes

Leaving the study early

Unable to use:
Patient expectations of treatment outcome ‐ no usable data.
Physical symptoms: VRMC, ICIDH ‐ no means or sds
Mental state: SCL‐90 ‐ no means or sds
Hypnotizability: SHCS ‐ no means or sds

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment?

Unclear risk

B ‐ Unclear
Moene 2003

Methods

Allocation: block randomisation
Blindness: Assessors blind
Duration: 3 months with 6 month follow up for the treatment group

Participants

Diagnosis: conversion disorder, motor type or somatization disorder with motor conversion symptoms according to DSMIIIR.
N= 44
Age: Mean 36.6yr (sd 11yr, range 18‐61yr)
Sex: 75% f
History: Mean age of onset 33.8yr (sd 11.3yr, range 15‐59yr). Mean length of symptoms 3.7yr (sd 4.7 months, range 2 months ‐16.7yr). 20 had suffered the same or other conversion symptoms. 16 had sudden onset of symptoms and 12 reported an identifiable stressor. 32 had received previous psychiatric care (9 as inpatient).16 used technical aids. 21 used medication of some kind. 75% married.
Setting: Outpatient psychiatric departments in Dordrecht and Delft, Netherlands.

Interventions

1. Introductory 1 hr session explaining the rationale for using hypnosis then hypnosis for 1hr a week for 10 weeks. Used a treatment manual. Encouraged to practice self hypnosis for 1/2hr/ day with audiotape to help. N=24
2. Waiting list for hypnosis. N=25.

Outcomes

Leaving the study early
Physical symptoms: VRMC, ICIDH
Mental state: SCL‐90
Hypnotizability: SHCS

Unable to use:
Patient expectations of treatment outcome ‐ no usable data.
6 month follow up ‐ only results for treatment group.

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment?

Unclear risk

B ‐ Unclear

HRSA = Hamilton Rating Scale for Anxiety
SHCS = Stanford Hypnotic Clinical Scale for Adults
SCL‐90 = Symptom Checklist
VRMC = Video rating scale for motor conversion symptoms
ICIDH = International classification of impairments, disabilities and handicaps
SRSS = NAtional Institute of Mental Health Self‐ Rating Symptom Scale
f = female
m = male
PI = paradoxical intention therapy

Characteristics of excluded studies [ordered by study ID]

Ir a:

Study

Reason for exclusion

Behr 1996

Allocation: no control group

Bellamy 1989

Allocation: no control group

Berkwitz 1952

Allocation: no control group

Bhattacharyya 1971

Allocation: no control group

Binzer 1997

Allocation: no control group

Cardenas 1986

Allocation: no control group

Carter 1949

Allocation: no control group

Casacchia 1989

Allocation: randomised
Participants: people with chronic anxiety including conversion disorder
Interventions: Alpidem (a novel anxiolytic of imidazopyridine structure) versus placebo. Therefore no intervention consistent with the definition of psychosocial intervention.

Delargy 1986

Allocation: no control group

Dickes 1974

Allocation: no control group

Ellason 1997

Allocation: no control group

Fackler 1997

Allocation: no control group

Geetha 1980

Allocation: not randomised just 3 groups matched for age, sex, per capita income, duration of illness and type of illness.

Gooch 1997

Allocation: no control group

Grattan‐Smith 1988

Allocation: no control group

Guida 1954

Allocation: no control group

Hafeiz 1980

Allocation: no control group

Halpern 1944

Allocation: no control group

Hoogduin 1993

Allocation: no control group

Kotsopoulos 1986

Koufman 1982

Allocation: no control group

Krull 1990

Allocation: no control group.

Kupper 1947

Allocation: no control group

Lehmkuhl 1989

Allocation: no control group

Leslie 1988

Allocation: no control group

Pu 1986

Allocation: no control group

Puhakka 1988

Allocation: randomised
Participants: people with globus syndrome. Not conversion disorder.
Interventions: Occlusal adjustment (grind teeth to fit better together). Not psychosocial

Ramani 1982

Allocation: no control group

Rampello 1996

Allocation: randomised
Blindness: assessors blind
Participants: people with recurrent hysterical neurosis of the conversion type (DSM IIIR)
Interventions: haloperidol vs sulpiride. Therefore no intervention consistent with the definition of a psychosocial intervention.

Rangaswami 1985

Allocation: no control group

Russell 1950

Allocation: no control group

Scallet 1976

Allocation: Matched according to age, race, marital status and baseline clinical status then randomly assigned to 3 groups.
Blindness: double blind
Participants: people with chronic hysteria (Briquets syndrome) diagnosed by own psychiatrist. This is not consistent with our definition of conversion disorder.
Interventions: relaxation and central electrical stimulation versus relaxation and peripheral electrical stimuation versus relaxation and sham electrical stimulation. Therefore no intervention consistent with the definition of psychosocial intervention.

Shapiro 1997

Allocation: No control group

Shapiro 2004

Allocation: No control group

Speed 1996

Allocation: No control group

Suzuki 1979

Allocation: No control group

Turgay 1990

Allocation: no control group

Watanabe 1998

Allocation: no control group

White 1988

Allocation: no control group

Williams 1979

Allocation: no control group

Yaskin 1936

Allocation: no control group

Data and analyses

Open in table viewer
Comparison 1. INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Physical signs (any attacks in last 2 weeks, high=poor, short term) Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

0.17 [0.02, 1.22]
Analysis 1.1
Comparison 1 INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM, Outcome 1 Physical signs (any attacks in last 2 weeks, high=poor, short term).

Comparison 1 INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM, Outcome 1 Physical signs (any attacks in last 2 weeks, high=poor, short term).

2 Mental state (endpoint data, short term, HRSA, high=poor) Show forest plot

1

30

Mean Difference (IV, Fixed, 95% CI)

‐3.73 [‐6.96, ‐0.50]
Analysis 1.2
Comparison 1 INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM, Outcome 2 Mental state (endpoint data, short term, HRSA, high=poor).

Comparison 1 INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM, Outcome 2 Mental state (endpoint data, short term, HRSA, high=poor).

3 Leaving the study early (endpoint data, short term) Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
Analysis 1.3
Comparison 1 INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM, Outcome 3 Leaving the study early (endpoint data, short term).

Comparison 1 INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM, Outcome 3 Leaving the study early (endpoint data, short term).

Open in table viewer
Comparison 2. INPATIENT TREATMENT PROGRAMME + HYPNOSIS versus INPATIENT TREATMENT PROGRAMME + INDIVIDUAL SESSIONS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Leaving the study early ‐ short term Show forest plot

1

49

Risk Ratio (M‐H, Fixed, 95% CI)

0.88 [0.14, 5.79]
Analysis 2.1
Comparison 2 INPATIENT TREATMENT PROGRAMME + HYPNOSIS versus INPATIENT TREATMENT PROGRAMME + INDIVIDUAL SESSIONS, Outcome 1 Leaving the study early ‐ short term.

Comparison 2 INPATIENT TREATMENT PROGRAMME + HYPNOSIS versus INPATIENT TREATMENT PROGRAMME + INDIVIDUAL SESSIONS, Outcome 1 Leaving the study early ‐ short term.

Open in table viewer
Comparison 3. OUTPATIENT HYPNOSIS versus WAITING LIST

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Physical signs (endpoint data, short term, high=poor) Show forest plot

1

43

Mean Difference (IV, Fixed, 95% CI)

2.10 [1.29, 2.91]
Analysis 3.1
Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 1 Physical signs (endpoint data, short term, high=poor).

Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 1 Physical signs (endpoint data, short term, high=poor).

1.1 Observation (VRMC, high =good)

1

43

Mean Difference (IV, Fixed, 95% CI)

2.10 [1.29, 2.91]

2 Mental state (endpoint data, short term, SCL‐90, high =poor) Show forest plot

1

43

Mean Difference (IV, Fixed, 95% CI)

‐12.30 [‐44.28, 19.68]
Analysis 3.2
Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 2 Mental state (endpoint data, short term, SCL‐90, high =poor).

Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 2 Mental state (endpoint data, short term, SCL‐90, high =poor).

3 Physical disability Show forest plot

Other data

No numeric data
Analysis 3.3

Study

Intervention

Mean

sd

N

Notes

Interview data (ICIDH, high=poor)

Moene 2003

Hypnosis

13.2

10.6

20

Moene 2003

Controls

16.6

11.7

23

Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 3 Physical disability.

3.1 Interview data (ICIDH, high=poor)

Other data

No numeric data

4 Leaving the study early ‐ short term Show forest plot

1

49

Risk Ratio (M‐H, Fixed, 95% CI)

2.08 [0.42, 10.34]
Analysis 3.4
Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 4 Leaving the study early ‐ short term.

Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 4 Leaving the study early ‐ short term.

5 Hypnotisability (baseline, SHCS, high =good) Show forest plot

1

43

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐1.09, 0.89]
Analysis 3.5
Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 5 Hypnotisability (baseline, SHCS, high =good).

Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 5 Hypnotisability (baseline, SHCS, high =good).

Comparison 1 INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM, Outcome 1 Physical signs (any attacks in last 2 weeks, high=poor, short term).
Figuras y tablas -
Analysis 1.1

Comparison 1 INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM, Outcome 1 Physical signs (any attacks in last 2 weeks, high=poor, short term).

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Comparison 1 INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM, Outcome 2 Mental state (endpoint data, short term, HRSA, high=poor).
Figuras y tablas -
Analysis 1.2

Comparison 1 INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM, Outcome 2 Mental state (endpoint data, short term, HRSA, high=poor).

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Comparison 1 INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM, Outcome 3 Leaving the study early (endpoint data, short term).
Figuras y tablas -
Analysis 1.3

Comparison 1 INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM, Outcome 3 Leaving the study early (endpoint data, short term).

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Comparison 2 INPATIENT TREATMENT PROGRAMME + HYPNOSIS versus INPATIENT TREATMENT PROGRAMME + INDIVIDUAL SESSIONS, Outcome 1 Leaving the study early ‐ short term.
Figuras y tablas -
Analysis 2.1

Comparison 2 INPATIENT TREATMENT PROGRAMME + HYPNOSIS versus INPATIENT TREATMENT PROGRAMME + INDIVIDUAL SESSIONS, Outcome 1 Leaving the study early ‐ short term.

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Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 1 Physical signs (endpoint data, short term, high=poor).
Figuras y tablas -
Analysis 3.1

Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 1 Physical signs (endpoint data, short term, high=poor).

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Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 2 Mental state (endpoint data, short term, SCL‐90, high =poor).
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Analysis 3.2

Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 2 Mental state (endpoint data, short term, SCL‐90, high =poor).

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Study

Intervention

Mean

sd

N

Notes

Interview data (ICIDH, high=poor)

Moene 2003

Hypnosis

13.2

10.6

20

Moene 2003

Controls

16.6

11.7

23

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Analysis 3.3

Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 3 Physical disability.

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Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 4 Leaving the study early ‐ short term.
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Analysis 3.4

Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 4 Leaving the study early ‐ short term.

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Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 5 Hypnotisability (baseline, SHCS, high =good).
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Analysis 3.5

Comparison 3 OUTPATIENT HYPNOSIS versus WAITING LIST, Outcome 5 Hypnotisability (baseline, SHCS, high =good).

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Comparison 1. INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Physical signs (any attacks in last 2 weeks, high=poor, short term) Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

0.17 [0.02, 1.22]

2 Mental state (endpoint data, short term, HRSA, high=poor) Show forest plot

1

30

Mean Difference (IV, Fixed, 95% CI)

‐3.73 [‐6.96, ‐0.50]

3 Leaving the study early (endpoint data, short term) Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]
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Comparison 1. INPATIENT PARADOXICAL INTENTION THERAPY (PI) versus OUTPATIENT DIAZEPAM
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Comparison 2. INPATIENT TREATMENT PROGRAMME + HYPNOSIS versus INPATIENT TREATMENT PROGRAMME + INDIVIDUAL SESSIONS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Leaving the study early ‐ short term Show forest plot

1

49

Risk Ratio (M‐H, Fixed, 95% CI)

0.88 [0.14, 5.79]
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Comparison 2. INPATIENT TREATMENT PROGRAMME + HYPNOSIS versus INPATIENT TREATMENT PROGRAMME + INDIVIDUAL SESSIONS
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Comparison 3. OUTPATIENT HYPNOSIS versus WAITING LIST

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Physical signs (endpoint data, short term, high=poor) Show forest plot

1

43

Mean Difference (IV, Fixed, 95% CI)

2.10 [1.29, 2.91]

1.1 Observation (VRMC, high =good)

1

43

Mean Difference (IV, Fixed, 95% CI)

2.10 [1.29, 2.91]

2 Mental state (endpoint data, short term, SCL‐90, high =poor) Show forest plot

1

43

Mean Difference (IV, Fixed, 95% CI)

‐12.30 [‐44.28, 19.68]

3 Physical disability Show forest plot

Other data

No numeric data

3.1 Interview data (ICIDH, high=poor)

Other data

No numeric data

4 Leaving the study early ‐ short term Show forest plot

1

49

Risk Ratio (M‐H, Fixed, 95% CI)

2.08 [0.42, 10.34]

5 Hypnotisability (baseline, SHCS, high =good) Show forest plot

1

43

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐1.09, 0.89]
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Comparison 3. OUTPATIENT HYPNOSIS versus WAITING LIST
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