Pediatric Movement Disorders - Psychogenic Disorders

Description

A variety of unusual movements can occur in children with psychiatric disorders. In some cases, this is a response to anxiety, stress, depression, anger, or grief; however, in many cases, it is not possible to find a clear reason for the disorder. Psychogenic disorders span the full range of possible symptoms, including tremor, dystonia, ataxia, bradykinesia, and chorea. Although these disorders are probably not caused by injury to the brain, they may be just as disabling to the child. The child does not have control of the movements and may be unaware of the cause. In severe cases, the child can injure him or herself due to the movements. In some cases, the child appears to ignore an obvious abnormality. This is referred to by the French term "belle indifference." Psychogenic disorders may occur at almost any age.

Psychogenic movements are a type of "conversion disorder." Conversion disorders are thought to represent the physical expression of an intolerable psychic conflict. If the child does not have the insight, verbal ability, or strength to describe an internal conflict, the only expression of that conflict may be in a psychogenic movement disorder. It is important to distinguish between conversion disorders, which are involuntary and may represent a suppressed emotional turmoil, and "malingering" in which a child may purposefully simulate a disease in order to achieve some secondary gain such as attention, absence from school, or control of a family situation.

Please see the following topics related to psychogenic disorders below, and available on the left side of this page.

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Section Author: Terence Sanger, MD PhD
Scientific Reviewers: Leon Dure, MD, Associate Professor of Pediatrics and Neurology, The University of Alabama at Birmingham; Marjorie A Garvey, MD, Pediatrics and Developmental Neuropsychiatry Branch, NIMH, Human Motor Control Section, NINDS; Jonathan W. Mink, MD PhD, Associate Professor of Neurology, Neurobiology & Anatomy, and Pediatrics Chief, Child Neurology, University of Rochester Medical Center, Rochester, New York
Editor: Joy B. Leffler, NASW, AMIA