Inpatient Treatment of Functional Neurological Disorder: A Scoping Review, 2020, Gilmour and Jenkins

[Andy]

Background: The aim of this scoping review is to describe the characteristics of patients requiring admission to hospital for Functional Neurological Disorder (FND), assess interventions provided, and evaluate outcomes in the context of acute hospital presentation or elective admission with chronic symptoms (>3 months).

Methods: A scoping review was performed. Included articles described adult patients admitted with FND to an inpatient care setting. Articles focusing on psychogenic non-epileptic attacks were excluded. Results: The search strategy identified 1,963 citations. A total of 34 articles met inclusion criteria, with 458 patients (66% female) described. The pooled mean age of patients in all studies was 40.6 years. Eleven studies described patients with acute presentation and 16 studies described patients with chronic FND symptoms admitted to the hospital. Motor symptoms were most common. Interventions were most commonly physiotherapy and psychotherapy. Most studies reported partial or complete resolution of symptoms.

Conclusions: This scoping review summarizes the literature on the characteristics of patients admitted to hospital, both with acute and chronic symptoms, for inpatient treatment of FND. When comparing patients with acute to those with chronic symptoms, we found that acute presentations were older (46.9 vs 43.7 years) and had a higher representation of men (33% vs 30%). Those presenting with chronic symptoms were more likely to not improve or relapse. We postulate that early diagnosis and inpatient rehabilitation could have a positive impact on outcomes for patients with FND.

Paywall, https://www.cambridge.org/core/jour...oping-review/6624362FB6D6595E93873F1386C3AB67
Sci hub, https://sci-hub.tw/10.1017/cjn.2020.159

 

[rvallee]

Most studies reported partial or complete resolution of symptoms

I can't find anything supporting that statement in the paper. There is far too much heterogeneity, no standardization of concepts, let alone outcomes. None of this is even valid to begin with, this is not a serious process. Might as well evaluate the outcomes of psychic seances for all that this is relevant to real life.

Silly GIGO.

 

[Mithriel]

If you do not get better with their treatments they say it is because your behaviour has become too "entrenched" not that their diagnosis or treatments are wrong.

Stone and Sharpe's first paper on FND said that great care must betaken with motor problems as these diseases can be difficult to diagnose but that has been dropped over the years.