History of Childhood Trauma in Patients Presenting with Conversion Disorder

Abstract

Background: Conversion disorder, characterized by neurological symptoms without an identifiable organic cause, has historically posed diagnostic and therapeutic challenges. The role of psychosocial factors, especially childhood trauma, in the development of this disorder is increasingly recognized, yet the relationship remains under-explored in diverse populations. Objective: This study aimed to investigate the demographic characteristics, clinical features, and prevalence of childhood trauma among patients diagnosed with conversion disorder at a teaching hospital in Peshawar, enhancing understanding of the disorder's psychosocial dimensions. Methods: This observational study included 55 patients diagnosed with conversion disorder at the Department of Psychiatry, Khyber Teaching Hospital, Peshawar, from May 1, 2022, to April 30, 2023. Participants were diagnosed according to DSM-5 and ICD-10 criteria. Data were collected through detailed reviews of electronic medical records and structured interviews focusing on demographic data, clinical manifestations, and childhood trauma experiences. Childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ) and the Adverse Childhood Experiences (ACEs) questionnaire. Statistical analysis was performed using SPSS version 25 to calculate frequencies, means, and standard deviations. Results: Of the participants, 54.5% were female and 45.5% were male, with a significant number having only primary education (56%). The average age was 37.4 years (SD=10.2). Clinically, 81.8% reported motor symptoms, 54.5% had sensory symptoms, and 36.4% experienced seizure-like episodes. The average duration of symptoms was 18.6 months (SD=7.9). Childhood trauma was reported by 36.4% for physical abuse, 27.3% for sexual abuse, and 45.5% for emotional abuse. High CTQ scores indicated substantial trauma levels among participants. Conclusion: The study confirms a high prevalence of childhood trauma among patients with conversion disorder and underscores the need for a comprehensive, trauma-informed approach in managing these patients. The findings highlight the importance of considering psychosocial factors in the diagnosis and treatment of conversion disorder to improve patient outcomes.