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Abstract
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Aims: This case study aims to explore the clinical presentation, psychosocial dynamics, and therapeutic approach in a 13-year-old male patient diagnosed with conversion disorder. The study also seeks to understand the role of family dynamics and secondary gains in maintaining the disorder.
Methods: The patient, a 13-year-old boy, presented with a two-month history of leg weakness, leading to multiple referrals and extensive evaluations across various specialties, including neurology, orthopedics, and rheumatology. After ruling out organic causes, a diagnosis of conversion disorder was established based on DSM-5 criteria. The patient’s history, family dynamics, and symptom development were meticulously documented through clinical interviews, structured assessments, and projective tests. The therapeutic approach included pharmacotherapy with fluoxetine, psychoeducation, family counseling, and motivational techniques to address secondary gains and improve functional outcomes.
Results and Conclusion: The patient exhibited significant motor symptoms, including difficulty walking, which led to dependence on assistive devices. Symptoms such as eye blinking and urinary incontinence were noted but showed fluctuating patterns. Psychosocial evaluation revealed familial stressors, including parental conflicts and heightened maternal attention, potentially reinforcing the patient’s symptoms. Therapeutic interventions focused on reducing secondary gains, enhancing self-efficacy, and fostering emotional expression. Over time, the patient demonstrated gradual improvement, transitioning from using crutches to a single cane and resuming independent activities like school attendance. In the end, he successfully discontinued the use of assistive devices and reengaged in his daily life activities. This case underscores the importance of a multidisciplinary approach, addressing both psychological and familial factors, to achieve functional recovery in conversion disorder.
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