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المؤلفون: David L. Perez, Julie Maggio, Aneeta Saxena, Ellen Godena
المصدر: Neuropsychiatric Disease and Treatment. 16:2119-2134
مصطلحات موضوعية: medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Neurological examination, Neurological disorder, Neuropsychiatry, medicine.disease, 030227 psychiatry, Cognitive behavioral therapy, 03 medical and health sciences, 0302 clinical medicine, medicine, Psychogenic disease, Functional movement disorder, business, Psychiatry, Psychosocial, Conversion disorder, 030217 neurology & neurosurgery
الوصف: Functional neurological disorder (FND), a condition at the intersection of neurology and psychiatry, is a common and disabling outpatient referral to neurology and neuropsychiatry clinics. In this perspective article, we focus on the motor spectrum of FND (mFND), including individuals with functional movement disorders (FND-movt), functional limb weakness/paresis (FND-par) and functional [psychogenic non-epileptic/dissociative] seizures (FND-seiz). Over the past several decades, there have been dedicated efforts within the neurologic and psychiatric communities to create "rule-in" diagnostic criteria, as well as thoughtful approaches to the clinical interview, delivery of the diagnosis and the development of a patient-centered treatment plan. These advances allow the promotion of good clinical practices in the outpatient assessment and management of mFND. Informed by the literature and our prior clinical experiences, we provide suggestions on how to evaluate individuals with suspected functional motor symptoms - including conducting sensitive psychiatric and psychosocial screenings. Additional sections discuss common "rule-in" neurological examination and semiologic signs of motor FND, as well as approaches to deliver the diagnosis and formulate a treatment plan based on individual patient needs. To aid the development of shared (partially overlapping) expertise that catalyzes an interdisciplinary approach to mFND, the use of physiotherapy for therapeutic motor retraining and cognitive behavioral therapy to examine relationships between symptoms, thoughts, behaviors and emotions are also discussed. Additional clinical research is needed to further refine and operationalize the assessment and management of mFND, across clinics, healthcare settings and countries.
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المؤلفون: Christopher D. Stephen, Jessica Ranford, Julie MacLean, David L. Perez, Priyanka R Alluri, Olivia Comeau, Ann L. Hunt, W. Curt LaFrance, Ellen Godena
المصدر: Psychosomatics
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Sensory processing, Adolescent, Psychometrics, medicine.medical_treatment, Sensory system, Neurological disorder, Audiology, Anxiety, Article, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Arts and Humanities (miscellaneous), Seizures, Surveys and Questionnaires, Sensation, medicine, Psychogenic disease, Humans, Conversion disorder, Applied Psychology, Retrospective Studies, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, 030227 psychiatry, Psychiatry and Mental health, Cross-Sectional Studies, Conversion Disorder, Female, Perception, business, 030217 neurology & neurosurgery, Anxiety disorder
الوصف: Background Functional neurological disorder (FND) is a prevalent neuropsychiatric condition characterized by sensorimotor difficulties. Patients with FND at times report that sensory experiences trigger and/or exacerbate their symptoms. Sensory processing difficulties are also commonly reported in other psychiatric disorders frequently comorbid in FND, suggesting that contextualizing sensory profiles in FND within a biopsychosocial model may be clinically relevant. Objective To address this literature gap, we conducted a retrospective cohort study to examine sensory processing patterns and their relationship to other neuropsychiatric characteristics in patients with FND. Methods A retrospective chart review design was used to investigate sensory processing patterns, established with the Adolescent/Adult Sensory Profile self-report questionnaire, in 44 patients with FND. Univariate analyses of cross-sectional screening tests followed by multivariate linear regression analyses were performed to identify clinical factors associated with sensory processing scores in the FND cohort. Results Compared to normative data, most patients with FND reported sensory processing tendencies toward low registration, sensory sensitivity, and sensation avoiding. In multivariate regression analyses, the presence of a lifetime anxiety disorder independently predicted elevated low registration scores, while female gender and number of current medications independently predicted increased sensory sensitivity scores. In uncorrected univariate analyses only, individuals with psychogenic nonepileptic seizures were more likely to report increased sensory sensitivity and elevated low registration. Conclusion These preliminary findings support sensory processing difficulties in some patients with FND. Prospective and large sample size studies are needed to investigate relationships between sensory processing profiles and neuropsychiatric comorbidities, FND subtypes, and treatment outcomes.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a5cdbc5233d230196f4af42d1ff3bf06
https://europepmc.org/articles/PMC7329616/
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