Brain, Vol. 124, No. 1, 232-233,
January 2001
© 2001 Oxford University Press
Book reviews |
CONVERSION HYSTERIA: TOWARDS A COGNITIVE NEUROPSYCHOLOGICAL ACCOUNT.
Edited by Peter W. Halligan and Anthony S. David. 1999. Hove, UK: Psychology Press. Price £24.95. Pp. 292. ISBN 0-86377-651-5.
Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
Around one-third of the patients attending our clinics prove to have medically unexplained symptoms. Some of these, with especially dramatic complaints, will earn `the diagnosis which dare not speak its name'—hysteria. The path to diagnosis is not always smooth. Every neurologist must have encountered a clinical mystery which is finally dispelled by a highly relevant, and all too often unlooked-for, psychological revelation. Whether we are irritated or intrigued by such cases, competent practice obliges us to do our best to recognize and manage patients whose psychological predicaments are announced by neurological symptoms. The difficulties that we encounter in teasing out the psychological thread partly reflect our training. Few neurologists possess formal psychiatric expertise, with the result, often confusing and counterproductive for our patients, that hysteria is a disorder diagnosed by one hospital team but treated by another.
For similar reasons, I suspect that few of us apply precise criteria to