This page was translated automatically from Turkish. Read the original

This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0482

When the body speaks through dissociation: diagnostic challenges in neuropsychiatric mimicry

WHEN THE BODY SPEAKS DISSOCIATION: DIAGNOSTIC CHALLENGES IN NEUROPSYCHIATRIC MIMICRY

In two clinically convincing neurological presentations, dissociative and functional mechanisms were recognized only after prolonged neurological evaluation, highlighting that psychiatric assessment should be an early and active component of diagnostic reasoning rather than a step taken only after other diagnoses have been excluded.

The aim is to illustrate how dissociative mechanisms mimic primary neurological disorders in functional neurological presentations involving altered consciousness or atypical motor symptoms, and why diagnostic formulation is delayed. The method involved a retrospective, case-based analysis of two neuropsychiatric cases; neurological and psychiatric assessments were reviewed, and symptom phenomenology, symptom fluctuation, treatment response, and discrepancies from the expected neurological course were examined. In the first case, a patient admitted to intensive care with altered consciousness and agitation was treated for delirium and epileptic seizures; fluctuating symptoms that persisted despite treatment prompted a psychiatric consultation, which identified dissociative features associated with psychosocial stressors. In the second case, a patient with Parkinson’s disease who had achieved symptom remission following deep brain stimulation (DBS) developed atypical parkinsonian movements during a reduction in dopaminergic treatment and in temporal association with a psychological stressor; the abrupt onset and fluctuations inconsistent with neurodegeneration prompted psychiatric assessment, which identified a functional mechanism. Shared features across both cases were identified as fluctuating symptoms, inconsistency with the expected neurological course, an association with psychological stress, delayed psychiatric involvement, and diagnostic inertia. The authors report that complex and prolonged diagnostic processes arise in settings where neurological plausibility and technology-based confirmation dominate early decision-making. They conclude that treating dissociative and functional vulnerability as a core domain of clinical assessment rather than a residual diagnosis may reduce diagnostic delay and symptom chronicity while supporting more coherent, individualized treatment pathways. No numerical data or statistical analyses were presented in the poster.

All WCP 2026 summaries