FND Nope

[Sean]

This is an actual threat.

Yep. Take it to the police, and a lawyer.

 

[Immunert]

@cstruter thank you for sharing your very clear letter.

This is such an important issue. Undoubtedly patients being diagnosed as FND have very real symptoms, but there is a danger that an FND diagnosis shuts down other investigations, preventing identification of misdiagnoses.

I have before given the example of a friend on mainland Europe who experienced severe chest pain every time she bent forward following heart surgery. She was repeatedly told there was no organic basis for the pain, advised to push through the pain, to exercise more and offered counselling. Fortunately she ignored this advice and after over eighteen months of ‘doctor shopping’ did manage to get an X-ray that identified the eleven inch stainless steel surgical instrument sitting in her chest cavity.

We have no idea how often an FND diagnosis obstructs the diagnosis of an alternative potentially disabling or life threatening condition.

The way I understand it, that is not the same as being diagnosed with FND though. It seems like a big leap to make any claims about FND from that story.

 

[Peter T]

The way I understand it, that is not the same as being diagnosed with FND though. It seems like a big leap to make any claims about FND from that story.

My friend had been given several diagnoses and retrospectively I can not confirm what they were, however I can confirm that she was told there was no organic basis for her pain and that a number of doctors refused further investigation on that basis, even though had she followed the advice to push through the pain it could have caused serious, indeed potentially life threatening, physical trauma.

However, though different professionals use different terms and the meaning of those terms in every day clinical use is not always clear, I agree that my anecdote is not equivalent to a documented case study. Potentially unhelpfully I tend to regard the various terms, FND, MUS, etc as a single fuzzy set.

However we do have documented case studies of people who were unambiguously diagnosed as FND who were subsequently found to have significant and life threatening organic conditions. I am sceptical of FND as a useful diagnosis, so am a prejudiced reporter, however this does illustrate the risks of any diagnoses that encourages people discontinuing furthet investigation on the basis of a ‘functional’ or psychogenic diagnosis.