Functional neurological disorder is a feminist issue

Abstract

Functional neurological disorder (FND) is a common and disabling disorder, often misunderstood by clinicians. Although viewed sceptically by some, FND is a diagnosis that can be made accurately, based on positive clinical signs, with clinical features that have remained stable for over 100 years. Despite some progress in the last decade, people with FND continue to suffer subtle and overt forms of discrimination by clinicians, researchers and the public. There is abundant evidence that disorders perceived as primarily affecting women are neglected in healthcare and medical research, and the course of FND mirrors this neglect. We outline the reasons why FND is a feminist issue, incorporating historical and contemporary clinical, research and social perspectives. We call for parity for FND in medical education, research and clinical service development so that people affected by FND can receive the care they need.

Functional Overlay Model of Persistent Post-Concussion Syndrome

“…Raynor and Baslet described the historical understanding over the FND etiologies and highlighted that these heterogenic premises, as well as the variable response to treatments, could suggest that FNDs are in fact complex disorders of which clear etiology could be more related to the individual than to a pathological redundant pattern [60]. In some cases, as the diagnosis of FND could be the subject of inconsistencies and discrimination [61], efforts are currently made to diminish them. In this way, Mark [62] suggested that a major source of unfavorable response (in the patient-provider relationship) could be historical biases, while McLoughlin et al [61] pointed out that FND could be considered as a feminist issue fueled not only by historical aspects, but also by contemporary perspectives.…”

“…In some cases, as the diagnosis of FND could be the subject of inconsistencies and discrimination [61], efforts are currently made to diminish them. In this way, Mark [62] suggested that a major source of unfavorable response (in the patient-provider relationship) could be historical biases, while McLoughlin et al [61] pointed out that FND could be considered as a feminist issue fueled not only by historical aspects, but also by contemporary perspectives.…”

Die interdisziplinäre – integrative – Versorgung von funktionellen neurologischen Störungen

“…Allein schon die komplexen diagnostischen und therapeutischen Fragen, die sie klinisch aufwerfen können, tragen dazu bei, dass die erforderliche und grundsätzlich einen Erfolg versprechende Behandlung von FNS viel zu oft ausbleibt. Dazu kommt es trotz aller Fortschritte umso leichter, als an FNS leidende Menschen weiterhin subtilen und offenen Formen der Diskriminierung ausgesetzt sind, sei es durch Kliniker, Forscher und die Öffentlichkeit, und das rasch noch einmal mehr, wenn es sich um Frauen handelt 1 . Immer in Gefahr, ins „Niemandsland zwischen Neurologie und Psychiatrie“ 2 zu geraten, laufen FNS außerdem der überkommenen Organisation einer medizinischen Versorgung entgegen, in der die Trennung von somatischer und psychosozialer Medizin das Erkennen und Handeln im klinischen Alltag bestimmt.…”

Kaleidoscope

“…A recent paper powerfully argues that this is a feminist issue. McLoughlin et al 4 start with the stark data on enduring gender bias and discrimination in medicineimplicit and explicitin terms of diagnostics, treatment and follow-up. This is matched by a lack of research, including women participants more generally and in what they label 'stereotypically female disorders' more specifically, echoing the broader global societal burdens faced by women, from violence through poverty to social exclusion.…”