The Neuroconnective Endophenotype, A New Approach Toward Typing Functional Neurological Disorder: A Case-Control Study 2024 Bulbena-Vilarrasa et al

Abstract

Objective:
Functional neurological disorder (FND) is a core neuropsychiatric condition that includes both physical and mental symptoms. Recently, a validated clinical phenotype termed neuroconnective endophenotype (NEP), which includes several physical and psychological characteristics together with joint hypermobility (hypermobility spectrum disorders), was found at a significantly higher frequency among patients with anxiety. The purpose of the present study was to examine the presence of the NEP among patients with FND.

Methods:
The authors conducted a multicenter case-control study comprising 27 FND patients and 27 healthy control participants (matched by sex and age) ages 13 to 58 years. Eight questionnaires were administered. Proportional differences were examined with Student’s t tests, one-way analyses of variance, and chi-square tests.

Results:
Differences between FND patients and control participants were observed. FND patients had higher sensory sensitivity, increased prevalence of hypermobility features (including relevant physical signs and symptoms), greater frequency of polarized behaviors, a greater number of both psychiatric and physical comorbidities, and an increase in the characteristics and sensations typical of anxiety. Particularly striking was the presence of the hypermobility spectrum in more than 75% of FND patients compared with 15% among control participants.

Conclusions:
FND patients presented higher scores in all five dimensions included in the NEP. Thus, this phenotype, solidifying the original association between anxiety and the hypermobility spectrum, could help to identify an FND subtype when evaluating and managing FND patients, because it provides a new global view of patients’ physical and mental symptoms.

Paywall, https://psychiatryonline.org/doi/10.1176/appi.neuropsych.20240016

 

Nep in Dutch means fake. FND was bad, but a NEP diagnose (first sentence) will not be embrased by Dutch patients, I think.

 

Embarrassing nonsense. Always the same old nonsense. Psychosomatic medicine is an infinitely growing cancer.

 

Re-enactement of this process:

 

One clinic specifically with patients dx with psychogenic nonepileptic pseudoseizures, the other an anxiety clinic having dx'ed them with FND (consecutively). No surprise anxiety is seen more frequently in patients partly recruited from an anxiety clinic...

Apologies if I'm missing the point: the inclusion criteria didn't mention hypermobility. Are we assuming there's a confounder that makes an FND diagnosis more likely in those thought to be hypermobile?

Needed to meet all 4. Note that 30% also had fibromyalgia, 41% had "CFS" and 11% had POTS - which might be suggested as "better explained by any other medical disorder."

Odd definition of healthy, though they did not have psychiatric diagnoses. 7% had fibromyalgia, 4% had "CFS", 8% had POTS, 11% had vertigo, 4% had IBS. (Not sure how either 7% or 8% is achieved out of 27.)

 

Yes I almost bolded that and tagged Dave30th !

 

It's always worked before , why change a winning formula ?

 

But the 'experts' keep saying that it's one of the most common disorders seen in health care, possibly the most common problem. That seems to conflict a bit. Just a tiny bit. It's both one of the most common disorders and also rare. You can be anything if you want to.

Also, what I was thinking that this comes from an anxiety clinic and they hand out 'anxiety' questionnaires (which convenient happen to ask overlapping questions):

See, you know that any cat in that box is an asshole because it says so on the box.

- Person who made the box​