Dissociative Disorder Following Hospitalization and Invasive Medical Procedures: A Pediatric Case Report

Abstract

Psychosomatic symptoms in children may be frequent reasons for referral in pediatric practice. Recognition of these symptoms as psychosomatic may sometimes be difficult, leading to unnecessary hospitalization and invasive diagnostic procedures. Meanwhile hospitalization and invasive diagnostic procedures may themselves have a traumatic impact on child psychology and cause pathological dissociation. In this paper we report a 12-year-old boy who was admitted to hospital following a sudden onset of motor loss in his legs which led to his undergoing several invasive diagnostic procedures for the first time in his life. After comprehensive investigations no medical conditions were detected and he was eventually diagnosed with conversion disorder following psychiatric consultation. His condition returned almost to normal spontaneously after two days and he was discharged from hospital after 17 days of hospitalization. He then developed dissociative disorder following his discharge from hospital. We aim to discuss the clinical picture and the child's perception of the traumatic nature of invasive medical procedures in this particular case, the traumatic impact of hospitalization and invasive medical procedures on child mental health, and the importance of early recognition of symptoms of conversion or dissociative disorders in children. (Archives of Neuropsychiatry 2009; 46: 30-3)