Functional neurological disorder in Saudi Arabia: A retrospective study, 2023, Tayeb

Abstract

Objectives
To describe the clinical profile of a sample of Saudi patients with Functional Neurological Disorder (FND).

Method
A retrospective review of charts of FND patients seen from 2021-2023 at a neuropsychiatry clinic at an academic tertiary care center in Jeddah, Saudi Arabia.

Results
Out of 473 patients seen in the clinic, 52 (11%) had FND. Their mean age was 34 (standard deviation = 10.7), and 77% were female. Family disputes (39%) were the most reported risk factor, followed by sexual abuse (15%). The most common FND symptoms were nonepileptic seizures (61.5%) and abnormal movements (30.8%). Pain was reported by 57.7% and cognitive symptoms by 36.5%. FND symptoms were frequently attributed to supernatural causes (67.3%). During the last follow up visit, 53.9% of patients reported FND symptom improvement, whereas 21.2% reported no change, 10.2% reported worsening, and 15% were lost to follow-up. The proportion of patients without symptom improvement was higher among patients with cognitive symptoms (45.5% vs 18% respectively, X2 = 10.08, df = 3, P = .018). The mean number of visits was highest in patients reporting worsening and lowest among patients reporting no change (F = 4.21, P = .017).

Conclusion
The role of family disputes in FND in the Middle East, the role of supernatural concepts in how FND is perceived, and the relatively high rate of subjective improvement within this sample of Saudi FND patients merit exploration. Cognitive symptoms may be a prognostic indicator. Prospective multicenter research using standardized assessment scales is needed.

Paywall, https://journals.sagepub.com/doi/10.1177/00912174231215908

 

Are we talking about the neurologists or the patients?

 

Yes

 

Ha! Beyond parody.

No, not those beliefs, those other beliefs.

 

If anyone else is also confused by what is meant by mind-body dualism we have the thread I need a good summary of the problems with mind-body theory to help.

The author has also written Mind-Body dualism and medical student attitudes toward mental illness in Saudi Arabia (2022, The International Journal of Psychiatry in Medicine, paywall) which maybe explains their framing of this.

 

The introduction for Mind-Body dualism and medical student attitudes toward mental illness in Saudi Arabia is —

The biopsychosocial model of mental illness is the predominant paradigm through which mental illnesses are viewed in modern mental health care. This integrated model emphasizes the role of neurobiological causation for mental disorders without neglecting the roles of psychological, social, and environmental factors. This view of mental disorders embraces mind-brain monism, the philosophical stance that all mental phenomena are ultimately brain-based. The opposite philosophical stance is mind-brain dualism (MBD). As articulated by Rene Descartes, Mind-body dualism claims that mental phenomena are separate and independent of physical ones. This view is largely incompatible with modern neuroscience in an era where great advancements in neuroimaging and other techniques has bolstered a cerebro-centric approach to explaining mental disease.​

I don't think I've seen it written elsewhere that BPS emphasises neurobiological causation — quite the opposite.

Mind-body dualism beliefs are also potentially harmful in the clinical context as previous research has shown that such beliefs are associated with undue blame and stigmatization of patients with mental illness. Nevertheless, some mental health professionals and trainees continue to use MBD as a framework for understanding mental illnesses, which may lead them to conceptualize some disorders as “more biological” than others.
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So here, the framing is mind-body dualism is bad. Whereas in the thread's paper mind-body dualism "may also facilitate acceptance of a connection between the mind and the body".