Iatrogenic harm in functional neurological disorder 2024 Mcloughlin, Lee, Carson and Stone

Abstract

Functional Neurological Disorder (FND) is continuing to gain increasing recognition globally as a valid and potentially treatable disorder. Iatrogenic harm towards patients with FND is significant however, and has been around for centuries. Despite advances in our understanding around the aetiology, pathophysiology, and treatment of FND, many aspects of such harm continue to persist. Avoidance of iatrogenic harm has been highlighted by clinicians as one of the most important therapeutic considerations in FND, however, the sources and range of potential harms, or indeed ways to mitigate them, have not been previously summarised.

Using a combination of clinical and research experience and scoping review methodology, this review aims to describe the main sources of iatrogenic harm towards patients with FND, including harm from misdiagnosis, delayed diagnosis and treatment, direct harm from professional interactions, other stigma-related harms, harm related to diagnostic overshadowing and over-diagnosis of FND. We also describe some potential ways to address and prevent such harms, such as ways to reduce misdiagnosis with a focus on rule in signs, optimising teaching and communication, ensuring parity of FND with other medical conditions, and continued integration of patient and professional organisations.

Open access, https://academic.oup.com/brain/advance-article/doi/10.1093/brain/awae283/7750481

 

Based on a quick search, there doesn't seem to be any mention of harm from exercise programmes and the like.

 

Is FND genuinely a valid separate entity and comorbidity? I don't really understand the similarity and differences of FND to ME?

Isn't this a diagnosis now given to MEeps so that they can give GET? But maybe if it is a genuine entity such patients do benefit from exercise?

 

Maybe a new blog for @ME/CFS Skeptic, if not already in the making?
Iatrogenic (caused by doctors) harm because of FND.

 

Thanks for the suggestion. Currently don't have plans to write about this in the near future but others have written about something similar (that Long Covid is not a functional disorder):
https://www.statnews.com/2024/07/15/long-covid-not-functional-neurological-disorder/
https://www.mdpi.com/2075-4426/14/8/799

 

This is like the doctors who made ads recommending a cigarette brand that goes down smoothly down the throat tut-tutting the 'pseudoscience' that smoking causes cancer and other health problems. Negative level of self-awareness. It's stunning the sheer amount of total bullshit that comes out of medicine. Even more stunning is the wild applause that it gets.