What Is the Role of a Specialist Assessment Clinic for FND? Lessons From Three National Referral Centers.
J Neuropsychiatry Clin Neurosci
; 32(1): 79-84, 2020.
Article
de En
| MEDLINE
| ID: mdl-31587627
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.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Troubles psychosomatiques
/
Orientation vers un spécialiste
/
Trouble de conversion
/
Hôpitaux spécialisés
/
Maladies du système nerveux
Type d'étude:
Guideline
/
Observational_studies
/
Screening_studies
Limites:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Pays/Région comme sujet:
America do norte
/
Europa
Langue:
En
Journal:
J Neuropsychiatry Clin Neurosci
Sujet du journal:
NEUROLOGIA
/
PSIQUIATRIA
Année:
2020
Type de document:
Article