FND Journal Watch
FUNCTIONAL NEUROLOGICAL DISORDER JOURNAL WATCH
A select number of scientific papers will be summarized below. We try to choose papers that would also be useful for patients. We hope that some of these papers will be useful in guiding patients to contribute ideas to research done into their illness.
This is not an academic journal watch. Our program is working on developing a different website monitoring academic research into Functional Neurological Disorder.
Here, our intention is to update patients and interested professionals alike. Our hope is that patients with FND will become more active in shaping the research agenda into their condition
'To err is human, to correct is divine.'.
If you find anything that requires correction, or if you disagree with our brief commentary, please write to admin@fndprogram.ca
MISUNDERSTOOD OR MISDIAGNOSED
Canna M, Seligman R Dealing with the Unknown. FND and the Conversion of Cultural Meaning, Social Science and Medicine, 2020 Feb; 246 (Published online Dec 2019)
In this article, Canna and Seligman explain how cultural meanings and stigma shape the symptoms of Functional Neurological Disorder. The article is extensive and covers many areas relevant to culture and Functional Neurological Disorder. The authors' work extends beyond the neurological and the psychiatric models. They explain that an anthropological understanding of FND is needed in order to improve diagnosis and treatment.
Canna and Seligman also highlight the effects of dysfunctional encounters between patients and health professionals on diagnosis and treatment. They explain how these dysfunctional encounters play a role in patients' perception of being misdiagnosed. The clear presentation of the relationship between patients' sense of being misunderstood and patients' assumption of being misdiagnosed is very helpful. Perhaps managing assumptions of misdiagnosis should begin with addressing patients experience of being misunderstood. This is a mutual process, in which the patient is a partner. It is not merely a task for clinicians.
PUTTING ASIDE ASSUMPTIONS IN FND CARE
Stone J, Callaghan H, Robinson EJ, Carson A, Reuber M, Chalder T, Perdue I, Goldstein LH Predicting first attendance at psychiatry appointments in patients with dissociative seizures. Seizure. 2019 Nov 28;74:93-98.
New results from the CODES trial were published on November28, 2019 in SEIZURE. CODES is a multicentre study conducted in the United Kingdom. This study looks at patients who were diagnosed with non-epileptic seizures by neurologists. Patients from 27 UK centres are included. These patients were subsequently referred to psychiatry.
Concerns are sometimes raised that patients with this condition may disagree to psychiatric follow up. Some patients disagree with the diagnosis of non-epileptic or functional seizures, in favour of having an undiagnosed epilepsy or another neurological condition, but not psychiatric illness.
How often did these patients keep their psychiatry appointments? Appointment attendance was 81.4 %. This is a high level of attendance. Patients come to theri appointments regardless to the many factors assumed to predict non-attendance. Patients are attending their appointments, even if they are not fully convinced of the diagnosis. Many figures from general psychiatry clinics are much lower than 80%. First appointment is an opportunity for mutual understanding and explanation.