Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0029713 (immaturity)
 4,335 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case report discussed here presents the evolution of a conversion disorder (urinary retention) in response to a decision to terminate a pregnancy. According to the "Diagnostic and Statistical Manual of Mental Disorders" (DSM 3), the following are the current criteria for a diagnosis of conversion (psychogenic pain): the predominant disturbance is a loss of or alteration in physical functioning suggesting a physical disorder; psychological factors are judged to be etiologically involved as evidenced by 1 of the following--a temporal relationship exists between an environmental stimulus that apparently related to a psychological conflict or need and the initiation or exacerbation of the symptom, the symptom enables the individual to get support from the environment that otherwise might not be forthcoming, and the symptom enables the individual to avoid some noxious activity; it has been determined that the symptom is not under voluntary control; and the symptom cannot be explained by a known physical disorder or pathophysiologic mechanism. A 25-year old single white woman (para 0, gravida 1) was hospitalized for termination of pregnancy at 22 weeks of gestation. The patient told her physician that she did not know she was pregnant. The operative procedure was uncomplicated, and the patient was discharged. 5 days later she presented to the emergency room with the complaint that she was unable to void. Following catheterization, which recovered 800 mL of urine, the patient returned home. Within 24 hours she again complained of an inability to void. Admission to the gynecological service resulted in a 16-day stay involving a continued inability to void requiring repeated catheterizations. Psychiatric consultation revealed marked immaturity, an inappropriately labile affect, and indifference to her symptoms. A history of occasional substance abuse was elicited. Upon transfer to the psychiatric inpatient service, the patient began to void spontaneously. The reported incidence of psychiatric sequelae after therapeutic or legal abortion is low, but the degree of preabortion emotional difficulty appears in direct proportion to the incidence of postabortion behavioral complications. The selection of a target organ for conversion is often based upon its ability to achieve symbolic representation. In the case presented the anatomic proximity of the bladder and uterus is cogent with the Freudian concent of somatic compliance whereby a previous somatic injury or disease may dictate the conversion focus by reactivation of the original event.
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PMID:Conversion disorder following termination of pregnancy. 684 39