Strategic-behavioural intervention in the inpatient rehabilitation of non-organic (factitious/conversion) motor disorders.

Conversion or factitious disorders manifesting as chronic motor disorders are difficult and complex management problems. A number of published case studies and series have illustrated that these patients may respond to a rehabilitation program emphasizing physical therapies and behaviour therapy. However, this standard behavioral approach was not successful with the majority of our patients. In contrast, an alternative strategic-behavioral rehabilitation approach developed for intractable cases proved highly effective. Among 17 patients who underwent the strategic behavioural approach, 13 showed complete or near complete resolution of symptomatology. Nine of these successfully treated patients had previously failed to improve using a standard behavioral rehabilitation program.