Prognosis

In general the prognosis for symptoms of acute conversion or dissociation is good but that for longer-lasting symptoms is relatively poor. Carter (59,) showed that 70 per cent of 90 patients seen for acute conditions and followed up for 4 to 6 years were well and only seven could not work. The prognosis for monosymptomatic conversion is usually good, although in most series a few patients committed suicide, and there is a slightly increased mortality compared with the general population. In Ljungberg's follow-up study(60) the suicide rate among men was similar to that in the general population, but the rate for women was higher. Seven per cent of his male patients and 12 per cent of his female patients had attempted suicide. The average expectation of life in Ljungberg's patients was 15 per cent below that of general population. In a recent series from a specialist setting which is likely to represent severe disorders with much comorbidity, (61) about a third of patients had improved at follow-up, a third were unchanged, and a third were worse.

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