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    Hyterical Aphonia (25 Cases)

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    Ana Morais
    This document analyzes 25 cases of hysterical aphonia seen over 3 years at a tertiary care hospital in India. Hysterical aphonia, also known as functional loss of speech due to hysteria or bilateral adductor paralysis, was found in 3.2% of conversion disorder cases. The study found that 17 of the 25 cases were female, with a mean age of 18.4 years for females and 21.2 years for males. Stress from examinations or failures was the most common precipitating factor. Comorbid psychiatric disorders were present in 80% of cases, most commonly mixed anxiety and depressive disorder.

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    Hyterical Aphonia (25 Cases)

    Uploaded by

    Ana Morais
    39 views4 pages
    This document analyzes 25 cases of hysterical aphonia seen over 3 years at a tertiary care hospital in India. Hysterical aphonia, also known as functional loss of speech due to hysteria or bilateral adductor paralysis, was found in 3.2% of conversion disorder cases. The study found that 17 of the 25 cases were female, with a mean age of 18.4 years for females and 21.2 years for males. Stress from examinations or failures was the most common precipitating factor. Comorbid psychiatric disorders were present in 80% of cases, most commonly mixed anxiety and depressive disorder.

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    Hyterical aphonia (25 cases)

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    This document analyzes 25 cases of hysterical aphonia seen over 3 years at a tertiary care hospital in India. Hysterical aphonia, also known as functional loss of speech due to hysteria or bilateral adductor paralysis, was found in 3.2% of conversion disorder cases. The study found that 17 of the 25 cases were female, with a mean age of 18.4 years for females and 21.2 years for males. Stress from examinations or failures was the most common precipitating factor. Comorbid psychiatric disorders were present in 80% of cases, most commonly mixed anxiety and depressive disorder.

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    39 views4 pages

    Hyterical Aphonia (25 Cases)

    Uploaded by

    Ana Morais
    This document analyzes 25 cases of hysterical aphonia seen over 3 years at a tertiary care hospital in India. Hysterical aphonia, also known as functional loss of speech due to hysteria or bilateral adductor paralysis, was found in 3.2% of conversion disorder cases. The study found that 17 of the 25 cases were female, with a mean age of 18.4 years for females and 21.2 years for males. Stress from examinations or failures was the most common precipitating factor. Comorbid psychiatric disorders were present in 80% of cases, most commonly mixed anxiety and depressive disorder.

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    of 4

     

    ORIGINAL CONTRIBUTION
    Year : 2000  |  Volume : 54  |  Issue : 8  |  Page : 335-338
     

    Hysterical aphonia - an analysis of 25 cases

    MS Bhatia1, Laxmi Vaid2


    1
     Department of Psychiatry, University College of Medical Sciences & Guru Teg
    Bahadur Hospital, Dilshad Garden, Delhi-110095, India
    2
     Department of ENT University College of Medical Sciences & Guru Teg Bahadur
    Hospital, Dilshad Garden, Delhi-110095, India

    Correspondence Address:
    M S Bhatia
    D-1, Naraina Vihar, New Delhi 110028
    India

    PMID: 11143747

    How to cite this article:


    Bhatia MS, Vaid L. Hysterical aphonia - an analysis of 25 cases. Indian J Med Sci
    2000;54:335-8

    How to cite this URL:


    Bhatia MS, Vaid L. Hysterical aphonia - an analysis of 25 cases. Indian J Med Sci
    [serial online] 2000 [cited 2012 Mar 27];54:335-8. Available
    from: http://www.indianjmedsci.org/text.asp?2000/54/8/335/12173

    Term "Hysteria" has been derived from Greek word 'Hysteria' (uterus). As defined by
    Hippocrates, it is considered to be due to the diabolic possession in the middle ages. In
    simple Non Fredian terms, conversion is an unconscious expression of emotional
    conflicts in the form of physical symptoms. It is this unconscious expression that
    differentiates conversion hysteria from malingering or hypochondriasis. Earlier, hysteria
    was considered to be a female disease, but many studies have found it more common in
    females than males. [1],[2],[3],[4],[5] The incidence has been reported to be 6.5 to 10.6% in
    various studies probably because of variations in the diagnostic criteria used by different
    workers. [2],[3],[6],[7] Some of the prestntations of hysteria have not been studied in detail.
    They include aphonia which is defined as `loss of speech'. Hysterical aphonia is defined
    as functional loss of speech due to hysteria, also called bilateral adductor paralysis.
    Therefore the present study was undertaken to find out the sociodemographic and
    clinical details of hysterical aphonia.
     ¤ Material and Methods  

    The present study was conducted in a tertiary care teaching hospital. All the consecutive
    cases of hysterical aphonia were studied over a period of three years (August 1996 to
    July 1999). All the patients were subjected to detailed history taking, physical examina-
    tion and mental status examination. Relevant blood and radiological (CT Scan etc)
    investigations were done wherever required to assess the physical status. Indirect
    laryngoscope was done in every case to rule out the organic involvement of larynx. The
    patients having unreliable history and doubtful organi city were excluded. The
    associated comorbid psychiaric disorder was classified according to ICD-10 (WHO,
    1992). The sociodemographic and clinical details alongwith percipitating factors of the
    cases with hysterical aphonia were analysed at the end of the study period.

     ¤ Results  

    Out of total 796 cases of conversion disorder seen during the study period, 25 (3.2%)
    were having aphonia. There were 17 females and 8 males [Table 1]. Stress at exami-
    nation or failure was the comma nest precipitating factor [Table 2].

     ¤ Discussion  

    The incidence of hysteria in our psychiatric unit is estimated to be between 6-8%. [8]
    This is in comparison to 6.5% to 10.6% reported in various studies. [2],[3],[9],[10],[11]
    probably due to variations in the diagnostic criteria and the population studied. The
    incidence of hysterical aphonia among conversion disorder cases was 3.2%. There were
    17(6.8%) females and 8 (32%) males. Hysteria has been reported to be more common in
    females. [1],[2],[3],[4],[5] Mean age among females and males were 18.4 years and 21.2 years
    respectively. The age of onset reported by most of the workers2-4, 10, 12-14 is usually
    in adole scene or early childhood.

    Majority of studies 3, 8, 10, 13 have reported hysteria to be common among illiterate


    group or those who studied upto school levels. The present study, including all the
    conversion hysteria cases, also is in consensus with the above findings whereas in the
    hysterical aphonia group, majority of causes have studied upto primary class or high
    school.

    high school. In contrast to a number of studies3, 4, 8, 14, 15 a majority (60%) in the


    present study belonged to joint families. There were 76% from urban background which
    could be due to the facts that a majority attending the hospital belonged to urban
    background and also, a number of patients from rural background still go to the tra-
    ditional healers. Duration of symptoms in a majority was within 2 weeks. This is in
    contrast to other studies. [3],[8] which report the onset as insidious except that in army per-
    sonnel. [15] Hysterical aphonia also presents as a psychiatric emergency. In a majority of
    cases, stress of examination or a recent failure acted as a precipitating factor followed
    by quarelling at home. The presence of life events have been found to be more common
    in the onset of hysteria in prevous studies., [16],[17] The comorbid psychiatric disorders eg
    sleep disorders, eating disorders, suicidal attempts, depression, anxiety disorder have
    been reported8, 14, 16, 17 in hysteria. The present study also found comorbid
    psychiatric disorder in 80% cases, the most common being mixed anxiety and
    depression followed by generalized anxiety disorder etc. More studies are war ranted to
    study the epidemiological, personality profile, psychodynamics and outcome details of
    patients presenting with hysterical aphonia and other conversion disorders.

     ¤ Summary  

    Hysteria is a common neurotic disorder in psychiatric practice. Many of its conversion


    symptoms have not been studied in detail. In the present prospective study in a tertiary
    care teaching hospital, 25 cases of hysterical aphonia were analysed. There were 17
    females and 8 males. Mean age of presentation was 18.4 years in females and 21.2 years
    in males. Majority of patients were literate upto primary class, belonging to joint family
    and , had urban background. Duration of symptoms was within 2 weeks. Most common
    precipitating factor was stress of examination or failure followed by quarrels with peers
    or spouse. In 20% cases, cause was not known. Ca morbid psychiatric disorders were
    found in 80% cases, the most common being mixed anxiety and depressive disorder
    (36%) followed by generalized anxiety disorder (20%).

     
     ¤ References  

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