Psychological interventions for treating functional motor symptoms: A systematic scoping review of the literature, 2022, Beal et al

[Andy]

Abstract

Functional Movement Disorders (FMD) can be identified by limb weakness, gait disorders, or involuntary movements which are inconsistent with a neurological diagnosis. Despite the prevalence of such symptoms, there has been little consensus on models for treatment. This scoping review set out to identify the literature exploring the efficacy of psychological interventions for the treatment of FMD, either as a stand-alone intervention or as part of a multi-disciplinary team approach. Studies set in an adult inpatient and outpatient setting were considered for inclusion. The final review consisted of 33 papers; 13 reviewing psychological treatments only, and 20 reviewing multidisciplinary approaches that included a psychological intervention. This review of the literature reaffirms the inconsistency across treatment for FMD, although identifies a trend towards an MDT approach in recent years. The review also identifies areas where consistency in methodology may be beneficial in future research, in order to improve the validity of results for greater comparison of treatments. There are promising outcomes that support the continued investigation focused on an interdisciplinary, collaborative approach to care, for the reduction of symptoms.

Open access, https://www.sciencedirect.com/science/article/abs/pii/S0272735822000319

 

[rvallee]

There are promising outcomes that support the continued investigation focused on an interdisciplinary, collaborative approach to care, for the reduction of symptoms.

This is not a serious statement to put in a systematic review that finds wild inconsistencies and, at best, a convergence of ideas without any substantial basis. It's entirely on the basis of unsubstantiated claims of efficacy, not because there's any real evidence.

Despite the prevalence of such symptoms, there has been little consensus on models for treatment

Well, some of the big shots in the field have been saying for years that they have nailed this. In fact there has been a total consensus that it needs to be treated psychologically for well over a century by now, this review is still at the same stage. The precise formulation of snake oil is irrelevant, what matters is that it's snake oil.

We can't get funding to replicate useful findings from preliminary research in ME but psychosomatic medicine can run useless and biased preliminary studies in an endless loop while claiming that 1) it's effective and well-understood but also that 2) the best that can be said is that it shows "promising patterns" that need to continue to be studied in preliminary studies, even after a full century of doing just that.

I don't know if Einstein really said that "the definition of insanity is doing the same thing and expecting different results" but the fact that authorities continue to enable this pseudoscience, unable to muster the tiniest amount of intellectual and ethical courage needed to put a stop to this madness, is true insanity.

 

[Arnie Pye]

When doctors study what they call "functional movement symptoms" in patients I wonder what tests they do to find out if there is something non-functional going on before they decide the problem is functional? Or do they go straight for "something functional" at the earliest opportunity?

 

[rvallee]

Given a recent paper from some of the "leading voices" in FND who "diagnosed" people with FND after simply having watched videos of vaccine reactions (some of which could be faking for clicks or trolling, they were not authenticated and the people in the videos were not interviewed/examined), it seems they don't think they need to run any tests at all.

Not too long ago Henrik Vogt was doing the same thing with Bieber, who seems to have Lyme-triggered chronic illness, at a distance. It's supposed to be a principle that physicians should not diagnose people at a distance, but that's nothing the giant loophole of medical-but-not-medical can't fix.

That's also what McVeddy and Beard (or whatever they're called) did. Wessely built his career doing that, including dismissing the 9/11-triggered health problems as fear-triggered somatization at a distance. Seems to be common and accepted in the void of "de-medicalized" diseases.

 

[Sean]

Abstract

Functional Movement Disorders (FMD) can be identified by limb weakness, gait disorders, or involuntary movements which are inconsistent with a neurological diagnosis.

A extremely dodgy basis for a diagnosis. But true to form.

 

[Mithriel]

I agree with Sean. If patients are not pretending to have symptoms something is affecting the neurological process so there is always a neurological problem. Diagnosis is something that medics do using a set of historical formula.

For ideological reasons a group of doctors have decided that the physical working of the brain has been completely explained and all physical causes for error found leaving only a mysterious, undiscovered mechanism whereby thoughts can have a physical expression.

All this against genetic studies showing that myotonic dystrophy is seriously underdiagnosed for one.

They are like witchfinders, never wrong and willing to let patients burn.