The Syndrome of Functional Memory Disorder: Definition, Etiology, and Natural Course

Schmidtke, Klaus; Pohlmann, Susanne; Metternich, Birgitta

doi:10.1097/jgp.0b013e318187ddf9

Cited by 80 publications

(85 citation statements)

References 11 publications

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“…For example, when attention is removed from the task at hand (e.g., going into a room to retrieve an item) or even subconsciously, by being focussed on a life event, a resulting attentional slip (i.e., forgetting what the particular item was) can prompt people with FMD to misattribute these memory lapses to neuropathology. This can cause greater rumination and worry about memory slips as described in Schmidtke, Metternich and colleagues' work (8,26). Previous research has also shown that subjective memory complaints are frequently caused by psychiatric disorders, most commonly by a depressive disorder, and these patients are often seen in memory clinics (30).…”

Section: Discussionmentioning

confidence: 93%

“…Other factors that may be useful positive indicators of FMD include educational attainment level and certain personality traits, such as over achievement or perfectionism that can be conducive to worry that accompanies occasional attentional slips or memory failures (8). A vicious circle can enhance these concerns in FMD patients.…”

Section: Discussionmentioning

confidence: 99%

“…There is evidence that, at present, screening procedures are not working well and that the proportion of patients without dementia is increasing in memory clinics (4)(5)(6) The label 'Functional Memory Disorder' (FMD) has been proposed to describe those patients who experience subjective memory complaints and present to memory clinics but do not have an underlying neurodegenerative or psychiatric cause (7). Diagnostic criteria for FMD have been proposed by Schmidtke and colleagues (8), and include subjective memory complaints that affect functioning in everyday life, have been present for more than 6 months, and cannot be explained by a clear psychiatric cause. Whilst there is debate on how these research criteria could be utilised in clinical practice (9), they can be used as a basis for diagnosing those patients who come to the memory clinics but who do not fit criteria for a memory complaint compatible with a neurodegenerative aetiology.…”

Section: Introductionmentioning

confidence: 99%

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Distinctive neuropsychological profiles differentiate patients with functional memory disorder from patients with amnestic-mild cognitive impairment

Wakefield

Blackburn

Harkness

et al. 2017

Acta Neuropsychiatr.

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This article has been published in a revised form in Acta Neuropsychiatrica https://doi.org/10.1017/neu.2017.21. This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © Scandinavian College of Neuropsychopharmacology 2017.eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. Conclusion: Whilst subjective complaints are common within the FMD population, no objective impairment could be detected, even on a sensitive battery of tasks designed to detect subtle deficits caused by a early neurodegenerative brain disease. This study indicates that FMD patients can be successfully differentiated from patients with neurodegenerative memory decline by characterising their neuropsychological profile.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Distinctive neuropsychological profiles differentiate patients with functional memory disorder from patients with amnestic-mild cognitive impairment

Wakefield

Blackburn

Harkness

et al. 2017

Acta Neuropsychiatr.

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“…FMD diagnostic criteria were suggested by Schmidtke et al [20]; for a more extensive discussion of the nature of FMD, and the differences between FMD, Mild Cognitive Impairment (MCI) and Subjective Memory Complaints, see [1]. Participating patients were screened for depression using the Patient Health Questionnaire 9 (PHQ9) [21].…”

Section: Methodsmentioning

confidence: 99%

Towards diagnostic conversational profiles of patients presenting with dementia or functional memory disorders to memory clinics

Elsey

Drew

Jones

et al. 2015

Patient Education and Counseling

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YesObjective\ud \ud This study explores whether the profile of patients’ interactional behaviour in memory clinic conversations with a doctor can contribute to the clinical differentiation between functional memory disorders (FMD) and memory problems related to neurodegenerative diseases.\ud \ud Methods\ud \ud Conversation Analysis of video recordings of neurologists’ interactions with patients attending a specialist memory clinic. “Gold standard” diagnoses were made independently of CA findings by a multi-disciplinary team based on clinical assessment, neuropsychological testing and brain imaging.\ud \ud Results\ud \ud Two discrete conversational profiles for patients with memory complaints emerged, including (i) who attends the clinic (i.e., whether or not patients are accompanied), and (ii) patients’ responses to neurologists’ questions about memory problems, such as difficulties with compound questions and providing specific and elaborated examples and frequent “I don’t know” responses.\ud \ud Conclusion\ud \ud Specific communicative difficulties are characteristic of the interaction patterns of patients with a neurodegenerative pathology. Those difficulties are manifest in memory clinic interactions with neurologists, thereby helping to differentiate patients with dementia from those with FMD.\ud \ud Practical implications\ud \ud Our findings demonstrate that conversational profiles based on patients’ contributions to memory clinic encounters have diagnostic potential to assist the screening and referral process from primary care, and the diagnostic service in secondary care

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“…Patients were routinely encouraged to bring along a family member, friend or carer to the appointment. After receiving a 'gold standard' clinical diagnosis (confirmed on the basis of an initial assessment by a Consultant Neurologist with a special interest in memory disorders including the Addenbrooke's Cognitive Examination (ACE-R), a detailed neuropsychological test battery and magnetic resonance imaging (MRI) of the brain) 25 patients were selected for the purpose of interactional profiling-9 with a dementia diagnosis (average ACE-R score 56/100, range from 28-80) and 16 with functional memory complaints (average ACE-R score 93/100 range from 85-99) (for a definition of FMD please see Schmidtke et al, 2008;Schmidtke & Metternich, 2009). This study represents an initial analysis of the data from the memory clinic.…”

Section: Study Design and Subjectsmentioning

confidence: 99%

Conversational assessment in memory clinic encounters: interactional profiling for differentiating dementia from functional memory disorders

Jones

Drew

Elsey

et al. 2015

Aging & Mental Health

107

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Objectives: In the UK dementia is under-diagnosed and there is national variation in memory clinic service provision. At present the clinical differentiation between dementia and functional (nonprogressive) memory complaints is complex and involves extensive neuropsychological testing. Government initiatives on 'timely diagnosis' aim to improve the rate and quality of diagnosis for those with dementia. This study seeks to improve methods of diagnostic screening by analysing communication between clinicians and patients during diagnostic assessment and establishing conversational profiles from which clinicians can establish differential diagnoses.Method: The data corpus consists of video-and audio recording of 105 initial consultations between neurologists and patients referred to a UK memory clinic. Conversation analysis was used explore recurrent communicative practices within these data.Results: Two discrete conversational profiles began to emerge to help differentiate between patients with dementia and functional memory complaints based on, 1) whether the patient is able to answer questions about personal information; 2) whether they can display working memory in interaction; 3) whether they are able to respond to compound questions; 4) the time taken to respond to questions; and 5) the level of detail they offer when providing an account of their memory failure experiences.Conclusion: Conversational profiles can differentiate patients with dementia from those with functional memory complaints. Conversational profiling has potential clinical application; using conversation as a method of diagnostic screening and assessment could hold differential diagnostic value.

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The Syndrome of Functional Memory Disorder: Definition, Etiology, and Natural Course

Cited by 80 publications

References 11 publications

Distinctive neuropsychological profiles differentiate patients with functional memory disorder from patients with amnestic-mild cognitive impairment

Distinctive neuropsychological profiles differentiate patients with functional memory disorder from patients with amnestic-mild cognitive impairment

Towards diagnostic conversational profiles of patients presenting with dementia or functional memory disorders to memory clinics

Conversational assessment in memory clinic encounters: interactional profiling for differentiating dementia from functional memory disorders

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