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Multidisciplinary treatment for functional neurological symptoms: a prospective study.

Demartini, B; Batla, A; Petrochilos, P; Fisher, L; Edwards, MJ; Joyce, E (2014) Multidisciplinary treatment for functional neurological symptoms: a prospective study. J Neurol, 261 (12). pp. 2370-2377. ISSN 1432-1459 https://doi.org/10.1007/s00415-014-7495-4
SGUL Authors: Edwards, Mark John James

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Abstract

Although functional neurological symptoms are often very disabling there is limited information on outcome after treatment. Here we prospectively assessed the short- and long-term efficacy of an inpatient multidisciplinary programme for patients with FNS. We also sought to determine predictors of good outcome by assessing the responsiveness of different scales administered at admission, discharge and follow-up. Sixty-six consecutive patients were included. Assessments at admission, discharge and at 1 year follow-up (55%) included: the Health of the Nation Outcome Scale, the Hospital Anxiety and Depression Scale, the Patient Health Questionnaire-15, the Revised Illness Perception Questionnaire, the Common Neurological Symptom Questionnaire, the Fear Questionnaire and the Canadian Occupational Performance Measure. At discharge and at 1 year follow-up patients were also asked to complete five-point self-rated scales of improvement. There were significant improvements in clinician-rated mental health and functional ability. In addition, patients reported that their levels of mood and anxiety had improved and that they were less bothered by somatic symptoms in general and neurological symptoms in particular. Two-thirds of patients rated their general health such as "better" or "much better" at discharge and this improvement was maintained over the following year. Change in HoNOS score was the only measure that successfully predicted patient-rated improvement. Our data suggest that a specialized multidisciplinary inpatient programme for FNS can provide long-lasting benefits in the majority of patients. Good outcome at discharge was exclusively predicted by improvement in the HoNOS which continued to improve over the 1 year following discharge.

Item Type: Article
Additional Information: © The Author(s) 2014 Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
Keywords: Adult, Affect, Anxiety, Canada, Depression, Female, Follow-Up Studies, Hospitalization, Humans, Inpatients, Male, Middle Aged, Neurologic Examination, Patient Discharge, Prognosis, Prospective Studies, Psychiatric Status Rating Scales, Self Report, Surveys and Questionnaires, Time Factors, Humans, Neurologic Examination, Prognosis, Hospitalization, Patient Discharge, Questionnaires, Follow-Up Studies, Prospective Studies, Depression, Affect, Anxiety, Psychiatric Status Rating Scales, Time Factors, Adult, Middle Aged, Inpatients, Canada, Female, Male, Self Report, Functional neurological symptoms, Psychogenic neurological symptoms, Conversion disorders, Inpatient programme, Psychotherapy, Physiotherapy, Neurology & Neurosurgery, 1103 Clinical Sciences, 1109 Neurosciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Neuroscience (INCCNS)
Journal or Publication Title: J Neurol
ISSN: 1432-1459
Language: eng
Dates:
DateEvent
December 2014Published
20 September 2014Published Online
31 August 2014Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
UNSPECIFIEDDepartment of HealthUNSPECIFIED
PubMed ID: 25239392
Web of Science ID: WOS:000345383800015
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109516
Publisher's version: https://doi.org/10.1007/s00415-014-7495-4

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