Originally Posted by southblues

Can conversion disorder have a radical response to treatment due to placebo effect?

Originally Posted by Anacrusis

I am intrigued by this!

• If those with a psychosomatic MG-like disorder get better with treatments that they donīt really need (take Mestinon for example)
  Then how do they manage to counteract the physiological overdose side effects of a drug they never needed in the first place?!

Originally Posted by AnnieB3

A well-known MG expert said in a conference I attended on MG in 2004 (yes, an MGFA conference) that it takes an average of one year for a man to be diagnosed with MG but an average of seven years for a woman to be. I don't know what was more disturbing; the fact that it takes that long or the fact that he seemed to be accepting of it.

If our world does not stop treating women like second class citizens, we women may bring hysteria to a whole new level. This has to stop.

Originally Posted by wild_cat

Warning: This might turn into a bit of a rant

The main reason I have been given a 'psychosomatic' diagnosis and not MG is because I have fluctuating muscle weakness. My muscle weakness is 'exacerbated by heat & repetitive muscle use and improves with rest and cooling'. I have been firmly reassured that this kind of muscle behavior are all a part of my 'functional' symptoms.

My second neurologist directed me to a website about functional symptoms. The symptoms listed appear to include every system in the body, every symptom you could imagine, in any possible combination. So, with this in mind, it's plausible any illness could be labeled as psychosomatic, given the 'right' circumstances.

What I debate is how useful having a diagnosis such as 'functional' is helpful, given that so many patients with such different symptoms are all lumped into the same category. Given that – as Annie has pointed out – their diagnostic criteria for functional symptoms are so 'unscientific', it's hard, as far as I can see, to legitimize it in terms of objective testing.

The way I see it, ALL illnesses have a psychological AND physical impact. The idea of separating out the physical from the psychological and putting a diagnostic 'cause' in one or the other category is quite frankly, archaic.

To me, the terms 'functional', 'psychosomatic' or 'somatization' are simply terms used when the physician is unwilling (note, not unable) to think outside the box. As I read in an article recently, a 'functional' diagnosis is a problem with the patient/physician relationship, not with the patient.

In the 1950s patients with epilepsy and MS were relegated to mental institutions and given treatments such as electric shock therapy to 'cure' them for their 'psychosomatic' symptoms. This is before epilepsy and MS were well understood.

Just because a physician cannot find an immediately obvious diagnosis does not mean the patient is suffering from 'emotional' problems.

When you look at the statics of misdiagnosis rates for patients labeled with 'functional' symptoms, it comes in at about 5%. This may not seem much expressed as a percentage, but when you consider that that is 5 in every 100 people that's actually quite a lot.

An article written (amongst others) by the 'MG specialist' I have just seen, assessed 1144 neurology outpatients at a three year follow up. Among their findings was a major degree of clinician error in symptoms suggestive of MS at follow up, leading to confirmed diagnoses, as well as a host of other neurological organic diseases latterly diagnosed. Those that were classed as having their symptoms 'not at all explained by organic disease' amounted to 68% in young females, highlighting that unexplained symptoms are most predominant in this category. Out of the 1144, 5 had died by the time of follow up, those predominantly with 'non-epileptic' seizure.

I think that the reason I have been given a 'psychosomatic' label may have quite a bit to do with being young and female. I'm not sure how much it has to do with the 'male' physician (my first GP was female). I think it's a very difficult diagnosis to get away from once you have it.

The first neurologist I ever saw – before he had examined me or did any tests – told me I had 'a classic case of hysteria'. My parents thought I had had a stroke. I couldn't walk and could barely speak. Three years on I believe this diagnosis has stuck because following up physicians do not want to refute the original diagnosis. Therefore they simply don't engage with the patient or listen to what they have to say.

Originally Posted by AnnieB3

The only thing doctors should be focused on while evaluating patients is the truth.
Annie

Originally Posted by wild_cat

I think this is also a complex question, because it is a lot to do with how we perceive our symptoms.

Originally Posted by alice md

Provide(..) a release of negative emotions or even punitive actions under the guise of a respectful medical label… Kutz, I., Garb, R., and Kuritzky, A., Diagnosis of misdiagnosis: on some of the origins and functions of psychophysical misdiagnosis, Gen Hosp Psychiatry 5 (3), 197, (1983)

Originally Posted by Anacrusis

Thank you for all this inspiration! It is also interesting that looking for these truths can change and become fragmented
depending not only on personality but also which type of doctor you visit.

But when I traveled to a different country where new truths providing better alignment could be accessed via different medicinal cultural perspectives an MG researcher & neurologist told me the answer was atypical seronegative myasthenia going into remission....I had come full circle back to my own original suspicion all those years ago.....