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Outcome Measures for Functional Neurological Disorder: A Review of the Theoretical Complexities.

Nicholson, TR; Carson, A; Edwards, MJ; Goldstein, LH; Hallett, M; Mildon, B; Nielsen, G; Nicholson, C; Perez, DL; Pick, S; et al. Nicholson, TR; Carson, A; Edwards, MJ; Goldstein, LH; Hallett, M; Mildon, B; Nielsen, G; Nicholson, C; Perez, DL; Pick, S; Stone, J; and the FND-COM (Functional Neurological Disorders Core Outcome; FND-COM group collaborators are as follows (2020) Outcome Measures for Functional Neurological Disorder: A Review of the Theoretical Complexities. J Neuropsychiatry Clin Neurosci, 32 (1). pp. 33-42. ISSN 1545-7222 https://doi.org/10.1176/appi.neuropsych.19060128
SGUL Authors: Nielsen, Glenn Edwards, Mark John James Morgante, Francesca

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Abstract

The development and selection of optimal outcome measures is increasingly recognized as a key component of evidence-based medicine, particularly the need for the development of a standardized set of measures for use in clinical trials. This process is particularly complex for functional neurological disorder (FND) for several reasons. FND can present with a wide range of symptoms that resemble the full spectrum of other neurological disorders. Additional physical (e.g., pain, fatigue) and psychological (e.g., depression, anxiety) symptoms are commonly associated with FND, which also can be highly disabling with implications for prognosis, and warrant concurrent assessment, despite an unclear etiological relationship with FND. Furthermore, several unique clinical aspects of FND make it likely that the usual prioritization of "objective" (or clinician-rated) over "subjective" (or patient-rated) measures might not be appropriate. Self-report measures may be more clinically meaningful in this patient population. Despite being a common and disabling disorder, there has been little research into outcome measures in FND, and to date trials have largely used measures designed for the assessment of other disorders. An international FND Core Outcome Measure group (FND-COM) has been established to develop a consensus battery of outcomes for FND: a "core outcome set." In this perspective article, the authors reviewed the process of outcome measure development and selection before considering the specific features of FND affecting the development of a core outcome set, as well as a research agenda to optimize outcome measurement in this complex neuropsychiatric disorder.

Item Type: Article
Additional Information: The official published article is available online at https://doi.org/10.1176/appi.neuropsych.19060128
Keywords: Conversion Disorder, Functional Neurological Disorder, Outcome Measure, Psychogenic, and the FND-COM (Functional Neurological Disorders Core Outcome Measures) Group, FND-COM group collaborators are as follows, Conversion Disorder, Functional Neurological Disorder, Outcome Measure, Psychogenic, 1103 Clinical Sciences, 1109 Neurosciences, 1702 Cognitive Sciences, 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
1 January 2020Published
23 December 2019Published Online
21 September 2019Accepted
Publisher License: Publisher's own licence
PubMed ID: 31865871
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/111516
Publisher's version: https://doi.org/10.1176/appi.neuropsych.19060128

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