Neuropsychiatric Associations With Gender, Illness Duration, Work Disability, and Motor Subtype in a U.S. Functional Neurological Disorders Clinic Population

Abstract

The assessment of functional neurological disorders (FND) requires an interdisciplinary approach. The authors retrospectively reviewed charts for 100 outpatients with FND and used univariate and regression analyses to investigate neuropsychiatric associations with gender, illness duration, and work disability; secondary analyses evaluated for differences across motor FND subtypes. Men reported higher rates of cognitive complaints and functional weakness, whereas women endorsed increased past physical/sexual trauma. Number of self-reported medication allergies/sensitivities positively correlated with illness duration. Individuals with functional weakness compared with other motor FND subtypes exhibited lower rates of past psychiatric hospitalization and head trauma. This study supports the feasibility of integrating FND research.

Corticolimbic structural alterations linked to health status and trait anxiety in functional neurological disorder

“…Although still debated in the field,80 we have previously outlined the utility of studying patients across the motor FND spectrum using a transdiagnostic approach 33 34 46. In 100 consecutive patients with FND evaluated in our clinic, 1 in 4 showed mixed functional motor symptoms at initial evaluation, reflecting the inherent overlap across populations 35. Furthermore, a strength of this study is the ability to control for motor FND subtypes in within-group analyses.…”

Neuropsychiatric Factors Linked to Adherence and Short-Term Outcome in a U.S. Functional Neurological Disorders Clinic: A Retrospective Cohort Study

“…Details of patients referred to this clinic have been previously described. 22,23 Patients underwent an initial 1.5-hour semistructured clinical neuropsychiatric interview and physical examination by a dual-trained and board-certified neurologist-psychiatrist (D.L.P.). Nineteen patients were initially evaluated by a clinical fellow or resident supervised by this same neurologist-psychiatrist (D.L.P).…”

“…Independent variables with less than 20% variance across the 100 FND cohort were excluded from analyses. 23 To identify baseline variables associated with outcome variables, we first performed univariate tests (chi-square or unpaired two-tailed t tests). Variables with a statistically significant relationship with one of the dependent variables (p,0.05) were included in second-level multivariate logistic regression analyses.…”

“…Table 1 presents the baseline characteristics of patients included in this study. 23 The cohort included 51 patients with PNES (video-electroencephalogram documented, N532; clinically established, N53; probable, N53; and possible, N513), 41 individuals with functional weakness (36 with "positive" examination findings, four with suspected paroxysmal symptoms, and one with complete bilateral lower-extremity paralysis with unremarkable brain and spine MRI and nerve conduction studies), and 38 patients with FMD (clinically established, N537; possible, N51). Twenty-eight patients had mixed motor functional neurological symptoms.…”

“…We have previously published on the baseline characteristics of this cohort and identified neuropsychiatric factors associated with gender, illness duration, work disability status, and motor subtype. 22,23 Here, we…”