Stigma in functional neurological disorder (FND) – A systematic review 2024 McLoughlin, Carson, Stone et al

Highlights

• Stigma in FND is widespread, and few studies exist looking at stigma outside of functional seizures.
  
  
• This is the first mixed methods review to comprehensively analyse stigma in FND, to include all FND phenotypes.
  
  
• Stigma in FND is higher than other neurological conditions, and affects quality of life and caregiver burden.
  
  
• Stigma affects the patient on intrapersonal, interpersonal and systemic levels – leading to shame, harm and neglect.
  
  
• Few interventions exist to reduce stigma in FND.
  

Abstract

Objective
The purpose of this systematic review was to evaluate stigma and Functional Neurological Disorder (FND) regarding: 1) prevalence and associated factors, 2) the nature and context of stigma in FND, and 3) stigma-reduction interventions.

Methods
We searched four relevant databases from inception to December 2023, using search terms relevant to FND and stigma themes. We employed the method of synthesis by “aggregation and configuration” to synthesise and analyse the data into emergent themes.

Results
We found 127 studies, spanning 148 countries, involving 18,886 participants. Of these, 4889 were patients, 13,123 were healthcare professionals, and 526 were caregivers. Quantitatively, stigma has been mainly studied in patients with functional seizures, and was higher than patients with epilepsy in three studies. Stigma experienced by patients is associated with poorer quality of life and caregiver burden. We found 10 themes and 29 subthemes revealing stigma as a systemic process, with intrapersonal, interpersonal and structural aspects. Few studies examined the perspective of caregivers, the public or online community. We identified six anti-stigma interventions.

Conclusion
Stigma in FND is a layered process, and affects patient quality of life and provision of care. Stigma needs to be addressed from the top structures, at governmental level, so that appropriate care pathways can be created, giving patients with FND parity of esteem with other medical conditions.

Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0272735824000813

 

Oh, there is one. It'd be 100% effective: fire the whole lot of you and put an end to your harmful pseudoscientific nonsense.

Like a royal commission of dukes and barons examining discontent in the people about the ruling aristocracy, finding that negative impressions of the ruling aristocracy are an impediment to its stability.

It's actually amazing that they make a lot of interoception and self-awareness, when they themselves have none. There is a mention in the bits of article that are available that talk about how the tide is turning. I wonder if they actually believe it. I doubt it. But they'll be blaming tiktok and social media for that. It's never their fault, stuck in perpetual infancy, lacking object permanence and other features of basic awareness.