Conversion Disorder Research Articles

Conversion disorder: An integrated care approach.

Knowing how the diagnosis is made and the condition is managed effectively can help FPs fulfill their role in the multifaceted care of these patients.

STUDY ON CLINICAL PRESENTATIONS, LEVEL OF STRESS & ROLE OF FAMILY ENVIRONMENT AMONG DISSOCIATIVE DISORDER PATIENTS

Background: Dissociative disorder is a stress-related disorder usually present in adolescent and younger age group. It is also accompanied with significant impairment in activity of daily living and family relationship. Family environment plays important role in initiation and maintenance of symptoms and this put significant burden on family. To assess different types of clinical presentations, level of stress and role of family environment among dissociative disorder patients and check for association between sex distributions. Material and Method: This cross-sectional descriptive study was carried out on patients with primary diagnosis of dissociative disorder as per ICD-10 criteria coming to psychiatry outpatient department of Sri Aurobindo Medical College and Postgraduate Institute, Indore a premier tertiary care hospital situated at northern part of India, covering, and serving a large catchment area, during the period of 18 months. 80 patients were recruited for the purpose of study. The procedure and rationale for the study was explained to all subjects and informed written consent were taken in their local language. Patients were included after fulfilling inclusion criteria from both inpatients and outpatient department of psychiatry. Result: In our study, majority of the patients (48.75%) belonged to the age group 18-30 years. The prevalence rates decrease with age. 37.5% of the patients were between the age group 31-40 years and 13.75% were over the age of 40 years. In a study of 80 patients with dissociative (conversion) disorder, 77.5% were females and 22.5% were male. There was female predominance. Conclusion: Dissociative disorders are more common in females than males. It always occurs in the background of increased stressful life events and in the presence of significant psychosocial stressors. Future studies should be undertaken in a large sample with a prospective design to examine the impact of disease duration and other mediators, such as family type and coping style.

Clinician-rated outcomes of patients with functional neurological disorders treated in an outpatient clinic

BackgroundPatients with functional neurological (conversion) disorder (FND) have historically been difficult to treat. Outcomes have been studied in research trials, documenting improvements; however, limited information is available from a community-treated FND cohort. ObjectivesWe aimed to examine clinical outcomes in outpatients with FND treated with the Neuro-Behavioral Therapy (NBT) approach. These uncontrolled setting treatment data could complement more structured clinical studies results. MethodsWe conducted a retrospective chart review of consecutive patients diagnosed with FND, ages 17 to 75, who were treated with the NBT workbook at the Rhode Island Hospital Behavioral Health clinic between 2014 and 2022. NBT consisted of 45-minute, individual, outpatient sessions, in clinic or via telehealth with one clinician. Global Assessment of Functioning (GAF), and Clinical Global Impression (CGI) –Severity, and –Improvement were scored for every appointment. ResultsBaseline characteristics are available for 107 patients. Mean age at FND symptom onset was 37 years. Patients had a mix of FND semiologies, which included Psychogenic Nonepileptic Seizures (71%), Functional Movement Disorder (24.3%), Functional Sensory Disorder (14%), Functional Weakness (6.5%), and Functional Speech Disorder (5.6%). Clinical evaluation scores revealed improvements over time. ConclusionsWe describe a well-characterized sample of patients with various and mixed FND semiologies, who received manualized therapy, NBT, in an outpatient clinic. Patients had similar psychosocial profiles to those in clinical studies and displayed improvement in clinical measures. These results demonstrate the practicability of NBT for motor FND semiologies and for PNES, in a “real-world” outpatient practice, extending care beyond structured clinical trials.

Conversive and Factitious disorders: Differential diagnosis based on a case report

IntroductionConversive disorder is characterised by the presence of one or more involuntary neurological symptoms that are not due to a clear medical pathology. On the other hand, consciously simulated illnesses fall into two diagnostic categories: factitious disorders and malingering, which are differentiated by both the motivation for the behaviour and the awareness of that motivation. Factitious disorder behaviours are motivated by an unconscious need to assume the sick role, whereas malingering behaviours are consciously driven to achieve external secondary gains.ObjectivesStudy of the differences between conversion disorder and factitious disorder and their repercussions from a case of difficult diagnosis.MethodsBibliographic review of scientific literature based on a relevant clinical case.ResultsWe present the case of a 14-year-old male patient. Adoptive parents. Studying in high school. Social difficulties since childhood. He comes to the emergency department on several occasions referring stereotyped movements and motor tics in the four extremities with left cervical lateralization. Increase of these symptoms in the last month, so it was decided to admit him to the pediatric hospital. After observation and study of the patient’s movements with normal complementary tests he should return home. The following day he returned to the emergency department after an episode of dizziness, mutism and emotional block. It was decided to admit him to Psychiatry for behavioral observation and differential diagnosis.ConclusionsIn the assessment of patients it is essential to make an appropriate diagnosis taking into account the patient’s symptomatology and the patient’s background and life context. Conversion disorder is the unintentional production of neurological symptom, whereas malingering and factitious disorder represent the voluntary production of symptoms with internal or external incentives. They have a close history and this has been frequently confounded. Practitioners are often confronted to medically unexplained symptoms; they represent almost 30% of neurologist’s consultation. The first challenge is to detect them, and recent studies have confirmed the importance of “positive” clinical bedside signs based on incoherence and discordance. Multidisciplinary therapy is recommended with behavioral cognitive therapy, antidepressant to treat frequent comorbid anxiety or depression, and physiotherapy. Factitious disorder and malingering should be clearly delineated from conversion disorder. Factitious disorder should be considered as a mental illness and more research on its physiopathology and treatment is needed, when malingering is a non-medical condition encountered in medico-legal cases.Disclosure of InterestNone Declared

Somatoform disorders in out-patient psychiatric setting: An overview

IntroductionThe somatoform disorders are a group of psychiatric disorders that present with unexplained physical symptoms.ObjectivesThis study aimed at assessing the prevalence and risk factors of somatoform disorders (SD) and their types among patients attending a major psychiatric clinic in Duhok Governorate/Kurdistan Region of Iraq. Our secondary aim was to assess the common presenting symptoms of conversion disorder (CD).Methods637 subjects were randomly selected from the outpatient psychiatric clinic at Azadi Teaching Hospital in Duhok Governorate/Kurdistan Region of Iraq. Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition (Version 2.0) was applied to diagnose patients with SDs.ResultsIn our sample the prevalence of SD was 24%. CD comprised the vast majority of SD at 75.8%, followed by somatization disorder at 7.8% and undifferentiated SD at 5.2%. SD was most common (60.1%) in adolescents and young adults (ages 15-25 y.o.); (p <0.05), and female gender comprised most of the SD in our sample (75.8%; p <0.001)Although, more than two-third of the cases were from lower educational levels (illiterate and primary educational level) (67.3%), more than fifty percent were married (52.3%), majority were housewives (39.2%) and more than half of the cases were from urban areas (52.3%), but no significant association were found between SD and educational level, marital status, occupation, and residence (p-values were 0.218, 0.659, 0.072, 0.090 respectively). Regarding the symptomatic presentation of CD, vast majority of the cases presented with pseudo-seizures which comprised (81%), followed by motor symptoms which comprised (17.2%), and sensory symptoms which constituted (1.7%) only.ConclusionsSD was highly prevalent among patients attending a major outpatient psychiatric clinic in Duhok Governorate/Kurdistan Region of Iraq, and CD was the most common presenting form of SD. Younger age (adolescents and young adults) and female gender comprised the majority of cases. Interestingly, the most common presenting symptom of CD in our sample was pseudo-seizures.Disclosure of InterestNone Declared

Impact of mystical belief and traditional healing on the health-seeking practice of conversion disorder in middle- and low-income countries.

Conversion disorder is a somatoform condition in which patients present with a range of neurologic deficits and sensorimotor loss with no obvious pathology. There has been a rising trend in the incidence of conversion disease in countries with low socioeconomic backgrounds, accounting to be one-third of ambulatory visits in middle and low-income countries (MLIC). However, even with such a high prevalence health-seeking practice for conversion disorder is low in MLIC. One possible reason for such behavior could be the high prevalence of mystical beliefs and traditional healing in MLIC. Existing economic distress with limited healthcare resources convinces people to opt for traditional and local healers who make use of mystical and superstition beliefs prevalent in those regions to offer prospering and cheaper methods of treatment. In this scenario, addressing and counseling mythological fallacies and the use of an economically friendly 'holistic model' of treatment should be adopted in these countries.

Psychiatric comorbidities in patients with conversion disorder – A longitudinal study

ABSTRACT Background: The word conversion refers to the substitution of a somatic symptom for a repressed idea. The conversion disorder indicates the absence of organic disease or disproportionately small disease compared with the complaint. Methodology: Ninety-six patients of conversion were screened for psychiatric comorbidities and followed up for a period of 6 months. Results: There was significant number of different psychiatric illnesses among the patients and positive correlation also with duration of illness in subsequent follow-ups. Conclusion: Our study highlights the significantly high prevalence of psychiatric comorbidities in patients of conversion disorder in first and follow-up visits with major depressive disorder being the most common one. The propensity to wait for comorbid psychiatric symptoms in conversion disorder to become florid might be unproductive. Early intervention can forestall progression into potentially chronic psychiatric illness.

A study on psychiatric conditions in children with school refusal- A clinic based study.

School refusal is a broad term that encompasses a child-motivated refusal to attend or remain at school, or a clear and apparent difficulty in doing so. Different factors that may influence the development of school refusal include a genetic predisposition, the home and family environment, the school environment, and social pressures. the present study aimed at examining, the psychiatric diagnostic status of children and adolescents who presented with school refusal. 92 consecutive subjects who attended the Child guidance clinic at Tata Main Hospital Jamshedpur were taken up for this study. The Clinical Diagnosis was based on the classificatory system of the International classification of diseases-10(ICD-10) through interviews. findings show that the mean age of the patient was 9.6 years. The prominent psychiatric co-morbidity present was Childhood emotional disorder unspecified, separation anxiety, conversion disorder, over-anxiety disorder, and somatoform disorder. Among children who refuse school, emotional reasons and anxiety disorders are most prevalent. This calls for early recognition and appropriate culturally relevant intervention to ensure early return to school.

Management difficulties in a patient with conversion disorder with comorbid bipolar disorder

Conversion disorder has several co-morbidities. Bipolar disorder is one of them. There is no definitive treatment protocol for cases like this. In this report, we presented a case of a 30-years old female who had this kind of condition. Initially, she had a presentation like conversion disorder. But after giving her treatment, features of bipolar disorder had come to the surface. We faced many difficulties regarding the management of this patient. By this case, the clinicians would have a better understanding of this kind of condition. This report might help clinicians in the management of conversion disorder with comorbid bipolar disorder. Bang J Psychiatry 2022;36(2): 39-41

The natural history of terms describing functional (neurological) disorders in the medical literature of the last 60years.

Functional neurological disorders (FND), a subtype of functional disorders (FD), are a frequent motive for neurology referrals. The various presentations and the unknown physiopathology of FD have led to the multiplication of terms describing these disorders over the years. We examined the FD-related articles published from 1960 to 2020 in PubMed and PsycINFO databases. We searched for: psychogenic, somatization, somatoform, medically unexplained symptoms, hysteria, conversion disorder, dissociative, functional neurological disorder, and functional disorder. Use rates in the title, abstract, keyword, or MeSH fields were collected over successive 5-year periods. After correcting for off-topic results, we examined proportional distribution over time, term associations, and disciplinary fields (neurologyandpsychiatry). Term impact was estimated via H-index and number of citations. We found that none of the terms is prevailing in the recent medical literature. We observed three trends in the use rates: stability, increase, and decrease of use over time. While most of the terms were present in a stable proportion of the publications, hysteria and psychogenic lost popularity over time. We found a differential preference for terminology between disciplines. Functional neurological disorder showed the highest citation impact, yielding 10% of highly cited publications. We found a dynamic and evolving use of the different terms describing FD in the last 60years. Despite the tendency to use the term functional in the recent highly cited publications, its low prevalence and coexistence with several other terms suggest that a precise, explanatory and non-offensive term remains yet to be found.

500: DIAGNOSIS OF WERNICKE ENCEPHALOPATHY IN A PATIENT WITH UNDERLYING PSYCHIATRIC ILLNESS

Introduction: Wernicke’s encephalopathy (WE) is an acute neuropsychiatric syndrome caused by thiamine deficiency. Common causes include alcohol use, bariatric surgery, and hemodialysis. Description: Our case involves a 65-year-old female who initially presented with seizure-like activity. Subsequent presentations over months included dysphagia, behavioral changes, and confusion. Initial workup with EEG, CT head, MRI brain, CT soft tissue neck, and endoscopy was unremarkable. Further history revealed that after her mother’s death four months prior, she began to self-isolate and reduce oral intake. Patient was evaluated by psychiatry and was diagnosed with conversion disorder. The clinical course was complicated by worsening neurological symptoms and respiratory distress requiring mechanical ventilation. Repeat MRI brain showed increased T2 FLAIR signal in the periaqueductal gray matter and along the dorsomedial thalamus consistent with WE. Patient was started on thiamine and showed symptomatic improvement. Discussion: WE is a triad of oculomotor dysfunction, ataxia, and confusion. In an observational study by Chamorro et al, 92.7% of cases were due to excessive alcohol intake, 47.1% due to malnutrition, and 5.9% due to psychiatric illness. The diagnosis of WE is primarily clinical, yet the classic triad is reported in only 10% of cases. The most consistent characteristic is a change in mental status. Caine et al developed the clinical diagnostic criteria, which include dietary deficiencies, oculomotor abnormalities, cerebellar dysfunction, and altered mentation or mild memory impairment. A case series based on this criteria found that clinical features of WE vary between alcohol and non–alcohol-related etiologies. The classic triad was more common in alcoholics than in non-alcoholics. One of the main challenges is the rate of underdiagnosis, which can be due to a lack of clinical suspicion or atypical presentation. Hence, MRI is a useful test to support the diagnosis of WE with a sensitivity of 53% and specificity of 93%. MRI may demonstrate lesions with increased symmetrical signal intensity in the periaqueductal region, medullary bodies, medial thalami, and the tectum of the midbrain. Diagnosis of WE should be considered in patients with psychiatric illnesses and atypical neurologic presentation.

Psychogenic non-epileptic seizures in youth: Individual and family psychiatric characteristics.

Youth with psychogenic non-epileptic seizures (PNES) are an understudied group associated with significant medical and psychiatric morbidity. Several studies have examined characteristics associated with youth's development of this disorder, though the exploration of family factors including psychiatric illness, has been lacking. This study sought to establish the need for a more comprehensive future study. A retrospective chart review was conducted on patients who had been admitted and diagnosed with PNES at the epilepsy monitoring unit at Children's Hospitals and Clinics of Minnesota. A total of 62 patients were included. All patients were evaluated by an epileptologist and psychologist during their diagnostic admission. "Spells" in question were captured via video EEG monitoring. PNES youth and family risk factors were assessed. Mean age of PNES symptom onset was 13.9 years. Patients (73%) were diagnosed within 6 months of onset of symptoms. Histories of other impairing somatic complaints were present in the youth (54%), with 67% having prior psychiatric diagnoses. Experiencing suicidal ideation or thoughts of self-harm occurred in 47% of this sample. Family members were unaware of the history of these symptoms with 12% of the parent's reporting awareness. Family history of psychiatric disorders (first-degree relatives of patient) was present in 54% of the sample, with anxiety, depression and conversion disorder being the most commonly endorsed diagnoses. Youth with PNES present with comorbid psychiatric disorders, though prior assessment and treatment for these disorders was not common. Youth with PNES have history of suicidal ideation and thoughts of self-harm, though parental awareness of these co-occurring symptoms is limited. Family risk factors, such as history of psychiatric disorder in first degree relatives, was high. The impact of these family risk factors is understudied and should be further evaluated to better understand the impact on development and maintenance of this disorder in youth.

Attribution and Health Seeking Behavior of Family Members towards Conversion (Dissociative) Disorders

Introduction: Patients with conversion disorder (dissociative disorder) are common in various hospitals and communities in Pakistan. What people think about the disease decides what treatment they receive. Therefore, this analysis was held to determine the attribution and health seeking behaviours for conversion disorder. Study Design: A cross-sectional and exploratory hospital study. Place and Duration: In the department of Psychiatry and Behavioral Sciences PGMI /AMC / LGH, Lahore Pakistan for the duration from February 2022 to July 2022. Methods: A total of 60 patients were included in this study and selected with purposive sampling method. Conferring to the criteria of ICD 10; the analysis of dissociative disorder was made. A self-developed questionnaire was used. The help seeking behavior and knowledge regarding dissociative disorder was assessed by self developed questionnaire. Results: The results exhibited that the frequency of dissociative convulsions (26.8%) and possession and trance (33.3%) were higher than in the other groups. Similarly, 8 (13.3%) had stupor, 6 (10%) has motor disorders in all movement and (3.3%) has sensory disorders and (5%) had mixed dissociative disorder. It was found that the majority of family members seeking treatment from faith healer (63.3%), trailed by paramedics (11.7%) and doctors (25%). Of all subjects, 46.6% visited a mental health professional for more than 2 weeks, 31.7% visited them within 48 hrs to two weeks, and 21.7% within 48 hours. 38.3% of members answered to ailment as a physical cause. About 43.3% of participants said conversion disorder was a mental condition. The participants who replied disease as a supernatural problem were 40%. Solitary 35% of contributors believed that counseling, psychotherapy and medicine could cure conversion disorder, while 46.7% believed that a faith-healer might cure it. Conclusion: Societies in Pakistan still have their roots in ethnic practices and faith healing. It is very important to run the awareness program and work in co-operation with faith healers is significant. Keywords: Conversion (Dissociative) Disorder, Attribution, health seeking, attribution

Neutrosophic Cognitive Maps for the Analysis of the Factors in the proper Diagnosis of Conversion Disorder

Neutrosophic Cognitive Maps for the Analysis of the Factors in the proper Diagnosis of Conversion Disorder

Demographic data and clinical characteristics of patients with functional neurological (conversion) disorder

Demographic data and clinical characteristics of patients with functional neurological (conversion) disorder

Patterns and Characteristics of Intentional Self-inflicted Hand Injuries among Military Personnel: A Retrospective Study and Proposal of Treatment Algorithm.

This retrospective chart review study was conducted at a tertiary hospital in Riyadh, Saudi Arabia. Our inclusion criteria included military personnel patients who presented to the emergency department with intentional self-inflicted hand-related injuries between 2016 and 2018. A total of 274 cases were included; 241 (88%) were men. Injuries to the left hand (52.2%) were more common than injuries to the right hand. The most common injury site involved the little finger (45.6%). The majority were followed up (97.8%), and 28.8% of cases had a complication. The majority of fractures were managed with open reduction and internal fixation (63.9%). Moreover, the mean sick leave duration was 23 days. Self-inflicted injuries can be challenging to diagnose when patients are manipulative about the cause and mechanism. Most self-inflicted injuries involved the left little finger, and most were treated with open reduction and internal fixation. A self-inflicted injury is possible in the context of an unusual injury with a vague medical history.

Attachment style of patients diagnosed with psychogenic non-epileptic seizures at a tertiary Epilepsy Center in the Czech Republic.

Quality and type of early relationships with primary caregivers is considered one of the key factors in the etiopathogenesis of many mental disorders including depression, anxiety, and conversion disorders. This study focused on the type and quality of attachment style in adult patients with psychogenic non-epileptic seizures (PNES). We evaluated the demographic data and profiles of PNES patients (n = 262) and group of healthy volunteers (n = 51) measured by the Parental Bonding Inventory (PBI) and Experiences in Close Relationships (ECR) and Experiences in Close Relationships-Relationship Structure (ECR-RS). Significant differences in measured values between the two groups were identified; specifically, differences in the caregiver style-father and mother overprotection (PBI) was higher in the PNES group. The most frequent type of attachment in PNES was type 2 (preoccupied). Correlations between the PBI and ECR results were also found. This study highlighted certain attachment styles in patients with PNES and statistically significant differences between patients with PNES and a healthy sample. Some correlations between the results of the questionnaires with socio-demographic factors were found. The identification of specific patterns in attachment may be useful for further use in reaching a differential diagnosis and administering tailored psychotherapy of patients with PNES.

Toward a possible trauma subtype of functional neurological disorder: Impact on symptom severity and physical health.

As a group, individuals with functional neurological disorder (FND) report an approximately 3-fold increase in adverse life experiences (ALEs) compared to healthy controls. In patients with FND, studies have identified a positive correlation between symptom severity and the magnitude of ALEs. While not all individuals with FND report ALEs, such findings raise the possibility of a trauma-subtype of FND. This study investigated if patients with FND, with or without probable post-traumatic stress disorder (PTSD) and/or significant childhood maltreatment, differed in their symptom severity and physical health. Seventy-eight patients with FND were recruited (functional seizures, n = 34; functional movement disorder, n = 56). Participants completed self-report measures of symptom severity [Somatoform Dissociation Questionniare-20 (SDQ-20), Screening for Somatoform Disorders: Conversion Disorder subscale (SOMS:CD), Patient Health Questionniare-15 (PHQ-15)], physical health [Short Form Health Survey-36 (SF36-physical health)], childhood maltreatment [Childhood Trauma Questionnaire (CTQ)], and PTSD [PTSD Checklist-5 (PCL-5)]; a psychometric battery of other common predisposing vulnerabilities was also completed. To adjust for multiple comparisons, a Bonferroni correction was applied to all univariate analyses. Patients with FND and probable PTSD (n = 33) vs. those without probable PTSD (n = 43) had statistically significant increased scores on all symptom severity measures - as well as decreased physical health scores. In secondary post-hoc regression analyses, these findings remained significant adjusting for age, sex, race, college education, and: pathological dissociation; alexithymia; attachment styles; personality characteristics; resilience scores; functional seizures subtype; or moderate-to-severe childhood abuse and neglect scores; SOMS:CD and SDQ-20 findings also held adjusting for depression and anxiety scores. In a separate set of analyses, patients with FND and moderate-to-severe childhood abuse (n = 46) vs. those without moderate-to-severe childhood abuse (n = 32) showed statistically significant increased SDQ-20 and PHQ-15 scores; in post-hoc regressions, these findings held adjusting for demographic and other variables. Stratification by childhood neglect did not relate to symptom severity or physical health scores. This study provides support for a possible trauma-subtype of FND. Future research should investigate the neurobiological and treatment relevance of a FND trauma-subtype, as well as continuing to delineate clinical characteristics and mechanisms in individuals with FND that lack a history of ALEs.

Knowledge and emotional attitudes of health care practitioners regarding patients with psychogenic nonepileptic seizures.

Psychogenic nonepileptic seizures (PNESs) are paroxysmal events that resemble epileptic seizures without concomitant changes in electroencephalograms (EEGs) or any other physiological cause. These seizures are one of the most common and dramatic conversion disorders. First responders treat many PNES patients with unnecessary emergency abortive medication and sometimes even intubate them. Several of our PNES patients have complained they have experienced harsh attitudes from health care practitioners (HCPs), especially during their stay in the emergency room (ER). To assess the emotional attitude of HCPs toward PNES patients. We handed a questionnaire containing 23 questions regarding PNES patients to HCPs from emergency medicine, internal medicine, and neurology disciplines. The questions dealt with three categories: diagnosis, management, and emotional attitudes. Overall, 47 HCPs participated in this study: 11 ER, 18 internal medicine, and 18 neurology practitioners. The HCP from those disciplines showed high knowledge and good management practice of PNES patients. On the other hand, the HCPs agreed with most emotional attitude statements regarding PNES patients, reflecting a high percentage of negative emotional attitudes toward this group of patients. We did not find any correlation between negative emotional attitude and HCP department, profession, or seniority. Although HCPs in our center perform good management practice regarding PNES patients, most reported a negative emotional attitude. This finding implies that what PNES patients feel regarding the harsh attitudes is also reflected by HCP views. Emotional attitudes towards PNES patients may not depend solely on the level of knowledge of the HCPs.

Rare Mental Health Disorders Affecting Urologic Care: A Comprehensive Review.

Management of mental health illnesses and needs are important in fostering psychosocial support, interprofessional coordination, and greater adherence to treatment protocols in the field of urology. This can be especially true for mental health conditions that may greatly impact the presentation of a patient in the healthcare setting with urologic symptoms. This review describes the history, epidemiology, pathophysiology, clinical presentation, and treatment of somatic symptom disorder, illness anxiety disorder, compulsive sexual behavior/hypersexuality, factitious disorder, malingering symptoms, and conversion disorder in the realm of urology. Given the newly updated psychiatric diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, there has been a lack of studies reviewing how these illnesses may present in a urology patient encounter. Additionally, as these mental health illnesses may carry a rare incidence compared to other well-known mental health illness such as generalized depression or generalized anxiety disorder, we have found that the lack of provisions and recognition of the diseases can prolong the timeline for diagnosis and lead to an increased cost in both healthcare and quality of life of patients with these mental health illnesses. This review provides awareness on these mental health conditions which may greatly impact patient history and presentation within the field of urology. Additionally, urologic care providers may have an improved understanding of interdisciplinary management of such illnesses and the common symptoms patients may present with such diseases.