Treatment of Functional Neurological Disorders in Children and Adolescents Dr. Kasia Kozlowska Child and Adolescent Psychiatrist The Children’s Hospital at Westmead, The University of Sydney, Brain Dynamics Centre.
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Slide 1Dr. Kasia Kozlowska
Child and Adolescent
Westmead, The University of
Sydney, Brain Dynamics Centre.
CHW
assessments in the lab
(41 girls and 16 boys) aged 8.5 to 18 years
Sensory
• 14% nausea
• 30% dizziness
• 23% breathlessness
• 28% fatigue
Quality of attachment relationships
The rates of unresolved loss and trauma: 75%(n = 57/76) of children with
conversion disorders versus 12%(n = 9/76) of controls. (Kozlowska et al, 2011)
Copyright: Patricia M. Crittenden, 2001
ANTECEDENT LIFE EVENTS (range 1-10, mean 5.3)
Family conflict
a friend
Maternal mental illness
Paternal mental illness
Maternal physical illness
medicine)
The science and art of Medicine
Step 2
This doctor does not know, so we need to
find a doctor who does know and who can
help our child
with Somatic Symptoms." Harv Rev Psychiatry 21(6): 314-333.
Voon et al. 2010
0
500
1000
1500
2000
2500
3000
conversion
control
emotional states and in cognitive control
functions.
HPA Axis
Shaiba
limb jerking
non-epileptic seizure events
it normalises the symptoms
are good
35 61%
WELL IN-BETWEEN (attending school or working)
10 17.5%
DIFFERENT CHRONIC ILLNESS
Chronic and debilitating anxiety (n=1)
Eating disorder (n=1)
Factitious presentations (n=2)
(n=1)
9 16%
Discharge against medical advice following a child
protection notification (n=1); Family not contactable (n=1)
2 3.5%
complications)
Psychological interventions (address self
Treatment: Mind-body inpatient program
complications)
Psychological interventions (address self
School intervention
complications)
Psychological interventions (address self
Clinical papers
Kozlowska, K., M. English, et al. (2012). "Multimodal rehabilitation: A
mind-body, family-based intervention for children and adolescents
impaired by medically unexplained symptoms. Part 1: The program."
American Journal of Family Therapy 40(5): 399-419.
Kozlowska, K., M. English, et al. (2013). "Multimodal rehabilitation: A
mind-body, family-based intervention for children and adolescents
impaired by medically unexplained symptoms. Part 2: Case studies
and outcomes." American Journal of Family Therapy.
Chudleigh, C., K. Kozlowska, et al. (2013). "Managing Non-epileptic
Seizures and Psychogenic Dystonia in an Adolescent Girl with Preterm
Brain Injury." Harv Rev Psychiatry 21(3): 163-174.
Kozlowska, K., S. Foley, et al. (2012). "Fabricated illness: Working
within the family system to find a pathway to health " Family Process.
Breathing resources
www.coherence.com
Child and Adolescent
Westmead, The University of
Sydney, Brain Dynamics Centre.
CHW
assessments in the lab
(41 girls and 16 boys) aged 8.5 to 18 years
Sensory
• 14% nausea
• 30% dizziness
• 23% breathlessness
• 28% fatigue
Quality of attachment relationships
The rates of unresolved loss and trauma: 75%(n = 57/76) of children with
conversion disorders versus 12%(n = 9/76) of controls. (Kozlowska et al, 2011)
Copyright: Patricia M. Crittenden, 2001
ANTECEDENT LIFE EVENTS (range 1-10, mean 5.3)
Family conflict
a friend
Maternal mental illness
Paternal mental illness
Maternal physical illness
medicine)
The science and art of Medicine
Step 2
This doctor does not know, so we need to
find a doctor who does know and who can
help our child
with Somatic Symptoms." Harv Rev Psychiatry 21(6): 314-333.
Voon et al. 2010
0
500
1000
1500
2000
2500
3000
conversion
control
emotional states and in cognitive control
functions.
HPA Axis
Shaiba
limb jerking
non-epileptic seizure events
it normalises the symptoms
are good
35 61%
WELL IN-BETWEEN (attending school or working)
10 17.5%
DIFFERENT CHRONIC ILLNESS
Chronic and debilitating anxiety (n=1)
Eating disorder (n=1)
Factitious presentations (n=2)
(n=1)
9 16%
Discharge against medical advice following a child
protection notification (n=1); Family not contactable (n=1)
2 3.5%
complications)
Psychological interventions (address self
Treatment: Mind-body inpatient program
complications)
Psychological interventions (address self
School intervention
complications)
Psychological interventions (address self
Clinical papers
Kozlowska, K., M. English, et al. (2012). "Multimodal rehabilitation: A
mind-body, family-based intervention for children and adolescents
impaired by medically unexplained symptoms. Part 1: The program."
American Journal of Family Therapy 40(5): 399-419.
Kozlowska, K., M. English, et al. (2013). "Multimodal rehabilitation: A
mind-body, family-based intervention for children and adolescents
impaired by medically unexplained symptoms. Part 2: Case studies
and outcomes." American Journal of Family Therapy.
Chudleigh, C., K. Kozlowska, et al. (2013). "Managing Non-epileptic
Seizures and Psychogenic Dystonia in an Adolescent Girl with Preterm
Brain Injury." Harv Rev Psychiatry 21(3): 163-174.
Kozlowska, K., S. Foley, et al. (2012). "Fabricated illness: Working
within the family system to find a pathway to health " Family Process.
Breathing resources
www.coherence.com
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