Content analysis of views on the nature of functional neurological disorders

Carruthers, Elspeth; Fernandes, L.A.; Agrawal, Niruj; Poole, Norman

doi:10.1016/j.jpsychores.2020.110303

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…This indicates a more nuanced and varied perception of FND. A number of previous studies have tended to show that only a minority of people with FND attribute their symptoms even in part to psychological factors such as stressful life events, although in most studies a small group generally did [45–48]. This may reflect a number of issues including personal and societal stigma around the term ‘psychological’, and poor experiences with healthcare professionals presenting this model.…”

Section: Discussionmentioning

confidence: 98%

International online survey of 1048 individuals with functional neurological disorder

Butler

Shipston-Sharman

Seynaeve

et al. 2021

Euro J of Neurology

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Background and purpose Functional neurological disorder (FND) is common, and symptoms can be severe. There have been no international large‐scale studies of patient experiences of FND. Methods A patient questionnaire was created to assess FND patient characteristics, symptom comorbidities and illness perceptions. Respondents were recruited internationally through an open access questionnaire via social media and patient groups over a month‐long period. Results In total, 1048 respondents from 16 countries participated. Mean age was 42 years (86% female). Median FND symptom duration was 5 years, and median time from first symptom to diagnosis was 2 years. Mean number of current symptoms (core FND and associated) was 9.9. Many respondents had associated symptoms, for example fatigue (93%), memory difficulties (80%) and headache (70%). Self‐reported psychiatric comorbidities were relatively common (depression, 43%; anxiety, 51%; panic, 20%; and post‐traumatic stress disorder, 22%). Most respondents reported that FND had multiple causes, including physical and psychological. Conclusions This large survey adds further evidence that people with FND typically have high levels of multiple symptom comorbidity with resultant distress. It also supports the notion that associated physical symptoms are of particular clinical significance in FND patients. Dualistic ideas of FND were not supported by respondents, who generally preferred to conceptualize the disorder as one at the interface of mind and brain. The need for a broad approach to this poorly served patient group is highlighted. Potential selection and response biases due to distribution of the survey online, mostly via FND patient groups, are a key limitation.

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Section: Discussionmentioning

confidence: 98%

International online survey of 1048 individuals with functional neurological disorder

Butler

Shipston-Sharman

Seynaeve

et al. 2021

Euro J of Neurology

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“…FMDs entail involuntary (abnormal) movements that are significantly altered by distractive maneuvers and are inconsistent and incongruent with phenomenology described in neurological diseases [ 11 ]. They can present in overlap with other neurological conditions [ 12 ] and can greatly impact the quality of life [ 13 , 14 ]. Up to 18% of patients with a movement disorder may be diagnosed as FMDs.…”

Section: Introductionmentioning

confidence: 99%

Functional Movement Disorders during COVID-19: Psychological Distress, Affective Temperament and Emotional Dysregulation

Janiri

Petracca

Moccia

et al. 2023

JPM

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Background and objective: Functional movement disorders (FMD) represent a spectrum of psychosomatic symptoms particularly sensitive to stress. The COVID-19 pandemic has increased psychological distress worldwide and may have worsened FMD. The study aimed to confirm this hypothesis and to test whether in FMD there is a relationship between affective temperament, emotional dysregulation and psychological distress due to the pandemic. Methods: We recruited individuals with FMD, diagnosed them according to validated criteria and matched them with healthy controls (HC). Psychological distress and temperament were obtained using the Kessler-10 and the Temperament Evaluation of Memphis, Pisa and San Diego Autoquestionnaire, respectively. We used bootstrapped mediation analysis to test the mediator role of emotional dysregulation on the effect of temperament on psychological distress. Results: The sample consisted of 96 individuals. During the pandemic, 31.3% of the patients reported the need for urgent neurological care, and 40.6% reported a subjective worsening neurological condition. Patients with FMD presented with more psychological distress during the COVID-19 pandemic (F = 30.15, df = 1, p ≤ 0.001) than HC. They also reported more emotional dysregulation (F = 15.80, df = 1, p ≤ 0.001) and more cyclothymic traits (F = 14.84, df = 1, p ≤ 0.001). Cyclothymic temperament showed an indirect effect on COVID-19-related psychological distress, mediated by deficits in emotion regulation mechanisms (Bootstrapped LLCI = 0.41, ULCI = 2.41). Conclusion: Our results suggest that emotional dysregulation may represent a dimension mediating cyclotimic temperament response to the stressful effect of the pandemic and provide insight for developing intervention policies.

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