Review Factors associated with receiving a Functional Disorder diagnostic label: A systematic review 2025 Tattan, Rosmalen and Hanssen

Abstract

Objectives
Functional Disorders (FD) are highly prevalent conditions that are diagnosed based on the presence of specific patterns of somatic symptoms. Examples of FDs include Fibromyalgia and Irritable Bowel Syndrome. Many patients who meet the criteria do not receive a formal diagnostic label. This systematic review aims to assess factors associated with receiving an FD diagnostic label.

Methods
A systematic search of PubMed, PsycINFO, and Embase was performed following the PRISMA guidelines. All research methodologies and languages were included with a focus on experiences and impacts of receiving/having an FD diagnostic label. Excluded studies were those not mentioning diagnostic labels, only involving single pain symptoms, and studies solely focusing on functional neurological symptoms. Screening, data extraction and quality ratings (using the QuADS instrument) were performed by two independent reviewers.

Results
15 Studies were identified (10 quantitative and 5 qualitative). Our results show that female patients were more likely to receive an FD diagnostic label for their symptoms; other associations were less consistent and only found for specific labels or research designs. In general, quality of life and healthcare use did not seem to differ between patients with and without an FD diagnostic label. From the healthcare professional’s perspective there was doubt about giving an FD diagnostic label, mainly due to concerns of harm for patients. Quality of included studies was rated low to moderate.

Conclusion
Better understanding of factors associated with receiving or having an FD diagnostic label, independently from symptom development can help healthcare professionals make evidence-based decisions in labelling or not; however, high quality studies on this topic are urgently needed.

Open access

 

"Functional Disorder (FD) is an umbrella term that covers a wide group of conditions. FDs are common conditions that are diagnosed based on the presence of specific patterns of somatic symptoms [1]. The most well-known FDs are Fibromyalgia (FM), Chronic Fatigue Syndrome (CFS), and Irritable Bowel Syndrome (IBS) [2, 3]. FD conditions contribute to a significant number of healthcare visits, which results in high financial expenditures for individuals and healthcare systems [4–7]. In general, the physical limitations and mental burden caused by FD conditions are comparable to the limitations of well-defined medical diseases in the domains of quality of life and work participation [8]."

 

Quality of included studies were rated low to moderate. Why use those then?

 

Because presumably none were rated high.

 

Then they should say: we don’t have any data because the studies were crap. We need better studies.