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Articles by S. Wessely
Total Records ( 3 ) for S. Wessely
  R Kanaan , D Armstrong , P Barnes and S. Wessely

Conversion disorder (‘hysteria’) was largely considered to be a neurological problem in the 19th century, but without a neuropathological explanation it was commonly assimilated with malingering. The theories of Janet and Freud transformed hysteria into a psychiatric condition, but as such models decline in popularity and a neurobiology of conversion has yet to be found, today's neurologists once again face a disorder without an accepted model. This article explores how today's neurologists understand conversion through in-depth interviews with 22 neurology consultants. The neurologists endorsed psychological models but did not understand their patients in such terms. Rather, they distinguished conversion from other unexplained conditions clinically by its severity and inconsistency. While many did not see this as clearly distinct from feigning, they did not feel that this was their problem to resolve. They saw themselves as ‘agnostic’ regarding non-neuropathological explanations. However, since neurologists are in some ways more expert in conversion than psychiatrists, their continuing support for the deception model is important, and begs an explanation. One reason for the model's persistence may be that it is employed as a diagnostic device, used to differentiate between those unexplained symptoms that could, in principle, have a medical explanation and those that could not.

  N Jones , N. T Fear , N Greenberg , L Hull and S. Wessely

Background Little is known about the longer term occupational outcome in UK military personnel who require hospital-based treatment for mental health problems.

Aims To examine the documented occupational outcomes following hospital-based treatment for mental health problems within the British Army.

Methods Hospital admission records were linked to occupational outcome data from a database used for personnel administration.

Results A total of 384 records were identified that were then linked to occupational outcome after an episode of hospitalization. Seventy-four per cent of those admitted to hospital with mental health problems were discharged from the Army prematurely, and 73% of the discharges occurred in the first year following hospitalization. Discharge from the Army was associated with holding a junior rank, completing <5 years military service, having a combat role, being male and receiving community mental health team treatment prior to admission.

Conclusions Hospitalization for a mental health problem in a military context is associated with a low rate of retention in service. Outcome was not influenced greatly by duration of hospital stay; however, those who reported receiving individual rather than group-based therapy while in hospital appeared to do better.

  N Greenberg and S. Wessely

People who suffer from post-traumatic stress disorder (PTSD) are likely to find that their quality of life is substantially impaired. However, unlike other diagnoses, in order for clinicians to make a diagnosis of PTSD people have to be able to accurately recall the details of a traumatic incident. Yet recent evidence suggests that recall of such incidents is often unreliable. Clinicians should therefore exercise caution to avoid making inaccurate diagnoses.

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