Why functional neurological disorder is not feigning or malingering

In this Perspective, Edwards and colleagues present their opinion that functional neurological disorder is categorically different from feigning and malingering. They discuss clinical, epidemiological and experimental evidence in support of this view. Functional neurological disorder (FND) is one of the commonest reasons that people seek help from a neurologist and is for many people a lifelong cause of disability and impaired quality of life. Although the evidence base regarding FND pathophysiology, treatment and service development has grown substantially in recent years, a persistent ambivalence remains amongst health professionals and others as to the veracity of symptom reporting in those with FND and whether the symptoms are not, in the end, just the same as feigned symptoms or malingering. Here, we provide our perspective on the range of evidence available, which in our view provides a clear separation between FND and feigning and malingering. We hope this will provide a further important step forward in the clinical and academic approach to people with FND, leading to improved attitudes, knowledge, treatments, care pathways and outcomes.

Automated summary

In this Perspective, the authors argue that functional neurological disorder (FND) is fundamentally different from feigning and malingering based on clinical, epidemiological, and experimental evidence. FND is a common reason for seeking help from neurologists and can significantly impact individuals' quality of life. Despite the growing evidence regarding FND, there is still uncertainty among healthcare professionals about the authenticity of symptoms reported by FND patients and whether they are comparable to feigned symptoms or malingering. The authors aim to clarify this distinction through a comprehensive review of available evidence, hoping to improve attitudes, knowledge, treatments, care pathways, and outcomes for individuals with FND.