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What Is the Role of a Specialist Assessment Clinic for FND? Lessons From Three National Referral Centers.

Aybek, S; Lidstone, SC; Nielsen, G; MacGillivray, L; Bassetti, CL; Lang, AE; Edwards, MJ (2020) What Is the Role of a Specialist Assessment Clinic for FND? Lessons From Three National Referral Centers. J Neuropsychiatry Clin Neurosci, 32 (1). pp. 79-84. ISSN 1545-7222 https://doi.org/10.1176/appi.neuropsych.19040083
SGUL Authors: Edwards, Mark John James Nielsen, Glenn

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Abstract

OBJECTIVE: A growing interest in functional neurological disorders (FND) has led to the development of specialized clinics. This study aimed to better understand the structure and role of such clinics. METHODS: Data were retrospectively collected from clinical records at three national referral centers, two specifically for motor FND and one for FND in general. Data were for 492 consecutive patients referred over a 9- to 15-month period: 100 from the United Kingdom clinic, 302 from the Swiss clinic, and 90 from the Canadian clinic. Data included symptom subtype and duration, comorbid pain and fatigue, disability, and treatment recommendations. RESULTS: The mean age of the 492 patients was 44 years, and most (73%) were female. Most had a prolonged motor FND (mean symptom duration of 6 years); 35% were not working because of ill health, 26% received disability benefits, and up to 38% required a care giver for personal care. In the Swiss cohort, 39% were given a diagnosis of another somatic symptom disorder rather than an FND diagnosis. Pain was common in the United Kingdom (79%) and Canada (56%), as was fatigue (48% and 47%, respectively). Most patients (61%) were offered physiotherapy; referral to neuropsychiatry or psychology differed across centers (32%-100%). CONCLUSIONS: FND specialty clinics have an important role in ensuring correct diagnosis and appropriate treatment. Most patients with motor FND require specialized neurophysiotherapy. Patients readily accepted an integrated neuropsychiatric approach. Close collaboration between FND clinics and acute neurology facilities might improve early detection of FND and could improve outcomes.

Item Type: Article
Additional Information: Final published version available at https://doi.org/10.1176/appi.neuropsych.19040083
Keywords: Functional Movement Disorders, Functional Neurological Disorders, Functional Movement Disorders, Functional Neurological Disorders, 1103 Clinical Sciences, 1109 Neurosciences, 1702 Cognitive Science, Psychiatry
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: J Neuropsychiatry Clin Neurosci
ISSN: 1545-7222
Language: eng
Dates:
DateEvent
January 2020Published
7 October 2019Published Online
16 July 2019Accepted
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
PP00P3_176985Swiss National Science Foundationhttp://dx.doi.org/10.13039/501100001711
PubMed ID: 31587627
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111259
Publisher's version: https://doi.org/10.1176/appi.neuropsych.19040083

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