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

Aybek, Selma; Lidstone, Sarah C; Nielsen, Glenn; MacGillivray, Lindsey; Bassetti, Claudio L.; Lang, Anthony E; Edwards, Mark J (2020). What Is the Role of a Specialist Assessment Clinic for FND? Lessons From Three National Referral Centers. The journal of neuropsychiatry and clinical neurosciences, 32(1), pp. 79-84. American Psychiatric Association 10.1176/appi.neuropsych.19040083

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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:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Aybek, Selma and Bassetti, Claudio

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1545-7222

Publisher:

American Psychiatric Association

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

26 Nov 2019 10:03

Last Modified:

24 Jan 2020 01:31

Publisher DOI:

10.1176/appi.neuropsych.19040083

PubMed ID:

31587627

Uncontrolled Keywords:

Functional Movement Disorders Functional Neurological Disorders

BORIS DOI:

10.7892/boris.134864

URI:

https://boris.unibe.ch/id/eprint/134864

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