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4. Specialist physiotherapy for functional motor disorder in England and Scotland (Physio4FMD): a pragmatic, multicentre, phase 3 randomised controlled trial

Author

Beaves, Emily, Breen, David, Burness, Christine, Caddy, Simone, Callaghan, Hannah, Carberry, Andrew, Chetham, Luke, Clyne, Andrea, Cobb, Susie, Coebergh, Jan, Cook, Lewis, Cookson, Patrick, Cooper, Paul, Diamond, Clare, Drake, Lee, Dunn, Victoria, Gardiner, Paula, Gilbertson, Thomas, Golder, Dawn, Gregory, Rebecca, Harbinson, Helen, Higgins, Rory, Hoeritzauer, Ingrid, Irvine, Laura, Isaacs, Jeremy, Jay, Emily, Kearney, Danielle, Khan, Uzma, Magro, James, Mallam, Elizabeth, Harle, Eleanor, Massey, Luke, McRae, Sarah, Misra, Shagun, Mitchell, Steph, Moss, Cameron, Mountain, Esther, Murray, Shona, Newby, Rachel, Novak, Marianne, Ross, Annie, Rutherford, Anna, Sare, Gillian, Sears, Rhiannon, Sedley, Will, Singhal, Sumeet, Stanton, Biba, Stone, Charlotte, Szeto, Gillian, Tarr, Lauren, Teodoro, Tiago, Teweleit, Volker, Walsh, Michael, Warman, Rhian, Yogarajah, Mahinda, Nielsen, Glenn, Stone, Jon, Lee, Teresa C, Goldstein, Laura H, Marston, Louise, Hunter, Rachael Maree, Carson, Alan, Holt, Kate, Marsden, Jon, Le Novere, Marie, Nazareth, Irwin, Noble, Hayley, Reuber, Markus, Strudwick, Ann-Marie, Santana Suarez, Beatriz, and Edwards, Mark J

Published
2024
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5. Acceptance and Commitment Therapy plus usual care for improving quality of life in people with motor neuron disease (COMMEND): a multicentre, parallel, randomised controlled trial in the UK

Author

Andreou, Penny, Androulaki-Korakaki, Dynameni, Blakeley, Claire, Bridges, Gary, Campbell, Iain, Davenport, Brittany, Dee, Annily, Drewry, Nicola, Flood, John, Fox, Annemieke, Girling, Melissa, Glew, Ruth, Hartley, Nick, Hocking, Sian, Howell, Mark, Keetharuth, Anju, Makin, Selina, Marsh, Jessica, Mayberry, Emily, McDonald, Alexa, McPartland, Roy, Meldrum, Steven, Mobley, Amanda, Murphy, Donnchadh, O'Brien, Marie Claire, Oliver, Mark, Patel, Darshna, Phipps, Emma, Read, Jessica, Roberts, Rhys, Rooney, Natasha, Smith, Carla, Statham, Jo, Thompson, Cara, Varma, Priya, Walker, Anne Marie, Waterhouse, Simon, Gould, Rebecca L, McDermott, Christopher J, Thompson, Benjamin J, Rawlinson, Charlotte V, Bursnall, Matt, Bradburn, Mike, Kumar, Pavithra, Turton, Emily J, White, David A, Serfaty, Marc A, Graham, Christopher D, McCracken, Lance M, Goldstein, Laura H, Al-Chalabi, Ammar, Orrell, Richard W, Williams, Tim, Noad, Rupert, Baker, Idris, Faull, Christina, Lambert, Thomas, Chhetri, Suresh K, Ealing, John, Hanratty, Anthony, Radunovic, Aleksandar, Gunawardana, Nushan, Meadows, Gail, Gorrie, George H, Young, Tracey, Lawrence, Vanessa, Cooper, Cindy, Shaw, Pamela J, and Howard, Robert J

Published
2024
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11. Investigating psychobiological causes and mechanisms in functional seizures and functional motor symptoms: Study protocol

Author

Pick, Susannah, primary, David, Anthony S., additional, Edwards, Mark J., additional, Goldstein, Laura H., additional, Hodsoll, John, additional, Millman, L. S. Merritt, additional, Nicholson, Timothy R., additional, Reinders, A.A.T.S., additional, Stanton, Biba, additional, Winston, Joel S., additional, Mehta, Mitul A., additional, Chalder, Trudie, additional, and Hotopf, Matthew, additional

Published
2024
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13. Acceptance and Commitment Therapy plus usual care for improving quality of life in people with motor neuron disease (COMMEND): a multicentre, parallel, randomised controlled trial in the UK

Author

Gould, Rebecca L, primary, McDermott, Christopher J, additional, Thompson, Benjamin J, additional, Rawlinson, Charlotte V, additional, Bursnall, Matt, additional, Bradburn, Mike, additional, Kumar, Pavithra, additional, Turton, Emily J, additional, White, David A, additional, Serfaty, Marc A, additional, Graham, Christopher D, additional, McCracken, Lance M, additional, Goldstein, Laura H, additional, Al-Chalabi, Ammar, additional, Orrell, Richard W, additional, Williams, Tim, additional, Noad, Rupert, additional, Baker, Idris, additional, Faull, Christina, additional, Lambert, Thomas, additional, Chhetri, Suresh K, additional, Ealing, John, additional, Hanratty, Anthony, additional, Radunovic, Aleksandar, additional, Gunawardana, Nushan, additional, Meadows, Gail, additional, Gorrie, George H, additional, Young, Tracey, additional, Lawrence, Vanessa, additional, Cooper, Cindy, additional, Shaw, Pamela J, additional, Howard, Robert J, additional, Andreou, Penny, additional, Androulaki-Korakaki, Dynameni, additional, Blakeley, Claire, additional, Bridges, Gary, additional, Campbell, Iain, additional, Davenport, Brittany, additional, Dee, Annily, additional, Drewry, Nicola, additional, Flood, John, additional, Fox, Annemieke, additional, Girling, Melissa, additional, Glew, Ruth, additional, Hartley, Nick, additional, Hocking, Sian, additional, Howell, Mark, additional, Keetharuth, Anju, additional, Makin, Selina, additional, Marsh, Jessica, additional, Mayberry, Emily, additional, McDonald, Alexa, additional, McPartland, Roy, additional, Meldrum, Steven, additional, Mobley, Amanda, additional, Murphy, Donnchadh, additional, O'Brien, Marie Claire, additional, Oliver, Mark, additional, Patel, Darshna, additional, Phipps, Emma, additional, Read, Jessica, additional, Roberts, Rhys, additional, Rooney, Natasha, additional, Smith, Carla, additional, Statham, Jo, additional, Thompson, Cara, additional, Varma, Priya, additional, Walker, Anne Marie, additional, and Waterhouse, Simon, additional

Published
2024
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14. A randomised controlled trial of acceptance and commitment therapy plus usual care compared to usual care alone for improving psychological health in people with motor neuron disease (COMMEND): study protocol

Author

Gould, Rebecca L., Thompson, Benjamin J., Rawlinson, Charlotte, Kumar, Pavithra, White, David, Serfaty, Marc A., Graham, Christopher D., McCracken, Lance M., Bursnall, Matt, Bradburn, Mike, Young, Tracey, Howard, Robert J., Al-Chalabi, Ammar, Goldstein, Laura H., Lawrence, Vanessa, Cooper, Cindy, Shaw, Pamela J., and McDermott, Christopher J.

Published
2022
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16. What is the extent of reliability and validity evidence for screening tools for cognitive and behavioral change in people with ALS? A systematic review.

Author

Didcote, Lyndsay, Vitoratou, Silia, Al-Chalabi, Ammar, and Goldstein, Laura H.

Subjects
LEGAL evidence, AMYOTROPHIC lateral sclerosis, MONTREAL Cognitive Assessment, BEHAVIORAL assessment, TEST validity
Abstract

This systematic review provides an updated summary of the existing literature on the validity of screening tools for cognitive and behavioral impairment in people with Amyotrophic Lateral Sclerosis (pwALS), and also focuses on their reliability. The following cognitive and behavioral screening tools were assessed in this review: the Edinburgh Cognitive and Behavioral ALS Screen (ECAS); the ALS Cognitive Behavioral Screen (ALS-CBS), the Mini Addenbrooke's Cognitive Examination (Mini-ACE), the Beaumont Behavioral Interview (BBI); the MND Behavior Scale (MiND-B); and the ALS-FTD Questionnaire (ALS-FTD-Q). A search, using Medline, PsychINFO and Embase (21/09/2023), generated 37 results after exclusion criteria were applied. Evidence of internal consistency, item-total correlations, inter-rater reliability, clinical validity, convergent validity, and structural validity were extracted and assessed and risk of bias was evaluated. The cognitive component of the ECAS was the tool with most evidence of reliability and validity for the assessment of cognitive impairment in ALS. It is well-suited to accommodate physical symptoms of ALS. For behavioral assessment, the BBI or ALS-FTD-Q had the most evidence of reliability and validity. The BBI is more thorough, but the ALS-FTD-Q is briefer. There is good but limited evidence for the reliability and validity of cognitive and behavioral screens. Further evidence of clinical and convergent validity would increase confidence in their clinical and research use. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Cost‐effectiveness of acceptance and commitment therapy for people living with motor neuron disease, and their health‐related quality of life.

Author

Keetharuth, Anju D., Gould, Rebecca L., McDermott, Christopher J., Thompson, Benjamin J., Rawlinson, Charlotte, Bradburn, Mike, Bursnall, Matt, Kumar, Pavithra, Turton, Emily J., Tappenden, Paul, White, David, Howard, Robert J., Serfaty, Marc A., McCracken, Lance M., Graham, Christopher D., Al‐Chalabi, Ammar, Goldstein, Laura H., Lawrence, Vanessa, Cooper, Cindy, and Young, Tracey

Subjects
ACCEPTANCE & commitment therapy, MOTOR neuron diseases, QUALITY of life, QUALITY-adjusted life years, COST effectiveness
Abstract

Background: Given the degenerative nature of the condition, people living with motor neuron disease (MND) experience high levels of psychological distress. The purpose of this research was to investigate the cost‐effectiveness of acceptance and commitment therapy (ACT), adapted for the specific needs of this population, for improving quality of life. Methods: A trial‐based cost–utility analysis over a 9‐month period was conducted comparing ACT plus usual care (n = 97) versus usual care alone (n = 94) from the perspective of the National Health Service. In the primary analysis, quality‐adjusted life years (QALYs) were computed using health utilities generated from the EQ‐5D‐5L questionnaire. Sensitivity analyses and subgroup analyses were also carried out. Results: Difference in costs was statistically significant between the two arms, driven mainly by the intervention costs. Effects measured by EQ‐5D‐5L were not statistically significantly different between the two arms. The incremental cost‐effectiveness was above the £20,000 to £30,000 per QALY gained threshold used in the UK. However, the difference in effects was statistically significant when measured by the McGill Quality of Life‐Revised (MQOL‐R) questionnaire. The intervention was cost‐effective in a subgroup experiencing medium deterioration in motor neuron symptoms. Conclusions: Despite the intervention being cost‐ineffective in the primary analysis, the significant difference in the effects measured by MQOL‐R, the low costs of the intervention, the results in the subgroup analysis, and the fact that ACT was shown to improve the quality of life for people living with MND, suggest that ACT could be incorporated into MND clinical services. [ABSTRACT FROM AUTHOR]

Published
2024
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18. How to do things with words: Two seminars on the naming of functional (psychogenic, non-epileptic, dissociative, conversion, …) seizures

Author

Wardrope, Alistair, Dworetzky, Barbara A., Barkley, Gregory L, Baslet, Gaston, Buchhalter, Jeffrey, Doss, Julia, Goldstein, Laura H., Hallett, Mark, Kozlowska, Kasia, LaFrance.Jr, W Curt, McGonigal, Aileen, Mildon, Bridget, Oto, Maria, Perez, David L., Riker, Ellen, Roberts, Nicole A., Stone, Jon, Tolchin, Benjamin, and Reuber, Markus

Published
2021
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19. Development and evaluation of a writing retreat program to build community and promote productivity in academic hospital medicine

Author

Bonafide, Christopher P., primary, Maletsky, Kristin D., additional, Kenyon, Chén, additional, Doupnik, Stephanie K., additional, Vasan, Aditi, additional, Rasooly, Irit R., additional, Goldstein, Laura, additional, Galligan, Meghan, additional, Hart, Jessica, additional, Ruppel, Halley, additional, Feudtner, Chris, additional, and Tenney‐Soeiro, Rebecca, additional

Published
2024
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25. Investigating psychobiological causes and mechanisms in functional seizures and functional motor symptoms: Study protocol.

Author

Pick, Susannah, David, Anthony S., Edwards, Mark J., Goldstein, Laura H., Hodsoll, John, Millman, L. S. Merritt, Nicholson, Timothy R., Reinders, A. A. T. S., Stanton, Biba, Winston, Joel S., Mehta, Mitul A., Chalder, Trudie, and Hotopf, Matthew

Subjects
INTEROCEPTION, LIFE change events, PSYCHOBIOLOGY, ECOLOGICAL momentary assessments (Clinical psychology), MENTAL illness, MAGNETIC resonance imaging, ISOMETRIC exercise
Abstract

Introduction: Advances have been made in understanding the aetiology of functional neurological disorder (FND); however, its pathophysiological mechanisms have not been definitively demonstrated. Evidence suggests interacting roles for altered emotional processing and interoception, elevated autonomic arousal, and dissociation, but there is limited evidence demonstrating their causal influence on specific FND symptoms. Our superordinate aim is to elucidate potentially shared and distinct aetiological factors and mechanisms in two common FND subtypes, functional seizures (FS) and functional motor symptoms (FMS). Methods: This study has a multimodal, mixed between- and within-groups design. The target sample is 50 individuals with FS, 50 with FMS, 50 clinical controls (anxiety/depression), and 50 healthy controls. Potential aetiological factors (e.g., adverse life events, physical/mental health symptoms, dissociative tendencies, interoceptive insight/sensibility) will be assessed with a detailed medical history interview and self-report questionnaires. A laboratory session will include a neurocognitive battery, psychophysiological testing, cardiac interoception and time estimation tasks and an isometric handgrip task. A subsample will undergo magnetic resonance imaging, including structural, resting-state and task-based scans combined with psychophysiological recording. Remote monitoring with ecological momentary assessment and wearables will measure variability in FND symptoms and their potential predictors/correlates for ≥2 weeks in patients' daily lives. Longitudinal follow-ups at 3, 6, and 12-months will monitor longer-term outcomes in the clinical groups. Discussion: This study employs multimodal research methods to rigorously examine several putative mechanisms in FND, at subjective/experiential, behavioural, and physiological levels. The study will test causal hypotheses about the role of altered emotional processing, autonomic arousal, dissociation and interoception in the initiation or exacerbation of FND symptoms, directly comparing these processes in FS and FMS to healthy and clinical controls. This is the first study of its kind, with potential to reveal important targets for prevention and treatment of FND in future. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Unravelling the influence of affective stimulation on functional neurological symptoms: a pilot experiment examining potential mechanisms.

Author

Pick, Susannah, Millman, L. S. Merritt, Ward, Emily, Short, Eleanor, Stanton, Biba, Reinders, A. A. T. Simone, Winston, Joel S., Nicholson, Timothy R., Edwards, Mark J., Goldstein, Laura H., David, Anthony S., Chalder, Trudie, Hotopf, Matthew, and Mehta, Mitul A.

Subjects
INTEROCEPTION, PSYCHOGENIC nonepileptic seizures, EPILEPSY, PILOT projects, AFFECT (Psychology), SOMATOFORM disorders, PATIENTS' attitudes, YOUNG adults
Published
2024
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32. 13 Predisposing, precipitating and perpetuating factors in functional neurological disorder: a pilot study

Author

Merritt Millman, LS, primary, Short, Eleanor, additional, Ward, Emily, additional, Sun, Yiqing, additional, Stanton, Biba, additional, Bradley-Westguard, Abigail, additional, Goldstein, Laura H, additional, Winston, Joel, additional, Mehta, Mitul, additional, Nicholson, Timothy, additional, Reinders, Simone, additional, David, Anthony, additional, Edwards, Mark, additional, Chalder, Trudie, additional, Hotopf, Matthew, additional, and Pick, Susannah, additional

Published
2023
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33. 12 A pilot investigation of interoceptive accuracy, awareness, and sensibility in functional neurological disorder

Author

Merritt Millman, LS, primary, Short, Eleanor, additional, Stanton, Biba, additional, Winston, Joel, additional, Nicholson, Timothy, additional, Mehta, Mitul, additional, Reinders, Simone, additional, Edwards, Mark, additional, Goldstein, Laura, additional, David, Anthony, additional, Hotopf, Matthew, additional, Chalder, Trudie, additional, and Pick, Susannah, additional

Published
2023
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34. Unravelling the influence of affective stimulation on functional neurological symptoms: a pilot experiment examining potential mechanisms

Author

Pick, Susannah, primary, Millman, LS Merritt, additional, Ward, Emily, additional, Short, Eleanor, additional, Stanton, Biba, additional, Reinders, AAT Simone, additional, Winston, Joel S, additional, Nicholson, Timothy R, additional, Edwards, Mark J, additional, Goldstein, Laura H, additional, David, Anthony S, additional, Chalder, Trudie, additional, Hotopf, Matthew, additional, and Mehta, Mitul A, additional

Published
2023
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39. Objective and subjective neurocognitive functioning in functional motor symptoms and functional seizures: preliminary findings

Author

Pick, Susannah, primary, Millman, L.S. Merritt, additional, Sun, Yiqing, additional, Short, Eleanor, additional, Stanton, Biba, additional, Winston, Joel S., additional, Mehta, Mitul A., additional, Nicholson, Timothy R., additional, Reinders, Antje A.T.S., additional, David, Anthony S., additional, Edwards, Mark J., additional, Goldstein, Laura H., additional, Hotopf, Matthew, additional, and Chalder, Trudie, additional

Published
2023
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41. Interoception in functional motor symptoms and functional seizures: Preliminary evidence of intact accuracy alongside reduced insight and altered sensibility

Author

Millman, L.S. Merritt, primary, Short, Eleanor, additional, Stanton, Biba, additional, Winston, Joel S., additional, Nicholson, Timothy R., additional, Mehta, Mitul A., additional, Reinders, Antje A.T.S., additional, Edwards, Mark J., additional, Goldstein, Laura H., additional, David, Anthony S., additional, Hotopf, Matthew, additional, Chalder, Trudie, additional, and Pick, Susannah, additional

Published
2023
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46. Functional neurological disorder is a feminist issue

Author

McLoughlin, Caoimhe, primary, Hoeritzauer, Ingrid, additional, Cabreira, Verónica, additional, Aybek, Selma, additional, Adams, Caitlin, additional, Alty, Jane, additional, Ball, Harriet A, additional, Baker, Janet, additional, Bullock, Kim, additional, Burness, Chrissie, additional, Dworetzky, Barbara A, additional, Finkelstein, Sara, additional, Garcin, Béatrice, additional, Gelauff, Jeannette, additional, Goldstein, Laura H, additional, Jordbru, Anika, additional, Huys, Anne-Catherine ML, additional, Laffan, Aoife, additional, Lidstone, Sarah C, additional, Linden, Stefanie Caroline, additional, Ludwig, Lea, additional, Maggio, Julie, additional, Morgante, Francesca, additional, Mallam, Elizabeth, additional, Nicholson, Clare, additional, O’Neal, Mary, additional, O‘Sullivan, Suzanne, additional, Pareés, Isabel, additional, Petrochilos, Panayiota, additional, Pick, Susannah, additional, Phillips, Wendy, additional, Roelofs, Karin, additional, Newby, Rachel, additional, Stanton, Biba, additional, Gray, Cordelia, additional, Joyce, Eileen M, additional, Tijssen, Marina AJ, additional, Chalder, Trudie, additional, McCormick, Maxanne, additional, Gardiner, Paula, additional, Bègue, Indrit, additional, Tuttle, Margaret C, additional, Williams, Isobel, additional, McRae, Sarah, additional, Voon, Valerie, additional, and McWhirter, Laura, additional

Published
2023
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49. Acceptance and Commitment Therapy for people living with motor neuron disease : an uncontrolled feasibility study

Author

Gould, Rebecca, Rawlinson, Charlotte K., Thompson, Ben, Weeks, Kirsty, Gossage-Worrall, Rebecca, Cantrill, Hannah A., Serfaty, Marc, Graham, Christopher, McCracken, Lance, White, David, Howard, Robert, Bursnall, Matt, Bradburn, Mike, Al-Chalabi, Ammar, Orrell, Richard, Chhetri, Suresh, Noad, Rupert, Radunovic, Aleksandar, Williams, Tim J., Young, Carolyn J., Dick, David, Lawrence, Vanessa, Goldstein, Laura, Young, Tracey, Ealing, John, McLeod, Hamish, Williams, Nicola, Weatherly, Helen, Cave, Richard, Chiwera, Theresa, Pagnini, Francesco, Cooper, Cindy, Shaw, Pamela, McDermott, Christopher, Group, COMMEND Collaboration, Gould, Rebecca, Rawlinson, Charlotte K., Thompson, Ben, Weeks, Kirsty, Gossage-Worrall, Rebecca, Cantrill, Hannah A., Serfaty, Marc, Graham, Christopher, McCracken, Lance, White, David, Howard, Robert, Bursnall, Matt, Bradburn, Mike, Al-Chalabi, Ammar, Orrell, Richard, Chhetri, Suresh, Noad, Rupert, Radunovic, Aleksandar, Williams, Tim J., Young, Carolyn J., Dick, David, Lawrence, Vanessa, Goldstein, Laura, Young, Tracey, Ealing, John, McLeod, Hamish, Williams, Nicola, Weatherly, Helen, Cave, Richard, Chiwera, Theresa, Pagnini, Francesco, Cooper, Cindy, Shaw, Pamela, McDermott, Christopher, and Group, COMMEND Collaboration

Abstract

Background: Motor neuron disease (MND) is a fatal, progressive neurodegenerative disease that causes progressive weakening and wasting of limb, bulbar, thoracic and abdominal muscles. Clear evidence-based guidance on how psychological distress should be managed in people living with MND (plwMND) is lacking. Acceptance and Commitment Therapy (ACT) is a form of psychological therapy that may be particularly suitable for this population. However, to the authors' knowledge, no study to date has evaluated ACT for plwMND. Consequently, the primary aim of this uncontrolled feasibility study was to examine the feasibility and acceptability of ACT for improving the psychological health of plwMND. Methods: PlwMND aged >= 18 years were recruited from 10 UK MND Care Centres/Clinics. Participants received up to 8 one-to-one ACT sessions, developed specifically for plwMND, plus usual care. Co-primary feasibility and acceptability outcomes were uptake (>= 80% of the target sample [N = 28] recruited) and initial engagement with the intervention (>= 70% completing >= 2 sessions). Secondary outcomes included measures of quality of life, anxiety, depression, disease-related functioning, health status and psychological flexibility in plwMND and quality of life and burden in caregivers. Outcomes were assessed at baseline and 6 months. Results: Both a priori indicators of success were met: 29 plwMND (104%) were recruited and 76% (22/29) attended >= 2 sessions. Attrition at 6-months was higher than anticipated (8/29, 28%), but only two dropouts were due to lack of acceptability of the intervention. Acceptability was further supported by good satisfaction with therapy and session attendance. Data were possibly suggestive of small improvements in anxiety and psychological quality of life from baseline to 6 months in plwMND, despite a small but expected deterioration in disease-related functioning and health status. Conclusions: There was good evidence of acceptability and fea

Published
2023
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50. Dissociation and its biological and clinical associations in functional neurological disorder: : systematic review and meta-analysis

Author

Campbell, Malcolm C., Smakowski, Abigail, Rojas-Aguiluz, Maya, Goldstein, Laura H., Cardeña, Etzel, Nicholson, Timothy R., Reinders, Anje A. T. S., Pick, Susannah, Campbell, Malcolm C., Smakowski, Abigail, Rojas-Aguiluz, Maya, Goldstein, Laura H., Cardeña, Etzel, Nicholson, Timothy R., Reinders, Anje A. T. S., and Pick, Susannah

Abstract

BackgroundStudies have reported elevated rates of dissociative symptoms and comorbid dissociative disorders in functional neurological disorder (FND); however, a comprehensive review is lacking.AimsTo systematically review the severity of dissociative symptoms and prevalence of comorbid dissociative disorders in FND and summarise their biological and clinical associations.MethodWe searched Embase, PsycInfo and MEDLINE up to June 2021, combining terms for FND and dissociation. Studies were eligible if reporting dissociative symptom scores or rates of comorbid dissociative disorder in FND samples. Risk of bias was appraised using modified Newcastle–Ottawa criteria. The findings weresynthesised qualitatively and dissociative symptom scores were included in a meta-analysis (PROSPERO CRD42020173263).ResultsSeventy-five studies were eligible (FND n = 3940; control n = 3073), most commonly prospective case–control studies (k = 54). Dissociative disorders were frequently comorbid in FND. Psychoform dissociation was elevated in FND compared with healthy (g = 0.90, 95% CI 0.66–1.14, I2 = 70%) and neurologicalcontrols (g = 0.56, 95% CI 0.19–0.92, I2 = 67%). Greater psychoform dissociation was observed in FND samples with seizure symptoms versus healthy controls (g = 0.94, 95% CI 0.65–1.22, I2 = 42%) and FND samples with motor symptoms (g = 0.40, 95% CI −0.18 to 1.00, I2 = 54%). Somatoform dissociation was elevated in FND versus healthy controls (g = 1.80, 95% CI 1.25–2.34,I2 = 75%). Dissociation in FND was associated with more severe functional symptoms, worse quality of life and brain alterations.ConclusionsOur findings highlight the potential clinical utility of assessing patients with FND for dissociative symptomatology. However, fewer studies investigated FND samples with motor symptoms and heterogeneity between studies and risk of bias were high. Rigorous investigation of the prevalence, features and mechanistic relevance of dissociation in FND is needed.

Published
2023

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