4.6 Article

Psychiatrists' attitudes towards functional neurological disorders: results from a national survey

Journal

FRONTIERS IN PSYCHIATRY
Volume 14, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fpsyt.2023.1216756

Keywords

functional neurological disorders; conversion disorders; psychosomatic medicine; psychiatric practice; education; survey

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This study examines the knowledge, opinion, and clinical approach of Italian psychiatrists towards functional neurological disorder (FND). The findings suggest that Italian psychiatrists tend to view FND as psychogenetic, primarily categorized as conversion disorders with a psychological etiology. They consider psychotherapy combined with pharmacological therapy as the most appropriate treatment, while physiotherapy is under-recognized. Promoting education about novel approaches to FND is crucial for improving care for patients.
IntroductionFunctional neurological disorder (FND) presents motor, sensory, and cognitive symptoms characterized by clinical signs incongruent with known neurological disease. Together with other health professionals, like neurologists, psychiatrists can play an essential role in diagnosing and managing these disorders. Hence, understanding their opinion and clinical experience with FND is of utmost importance to catch potential educational needs and improve healthcare services for patients. This study aims at assessing the knowledge, opinion, and clinical approach of Italian psychiatrists to FND. MethodsMembers of the Italian Society of Psychiatry completed a 14-item web-based survey investigating their approach to FND. Results. Overall, 174 questionnaires were completed. Our main findings suggest that Italian psychiatrists have a psychogenetic conceptualization of FND. Conversion disorders, in fact, is the term most frequently used by Italian psychiatrists to refer to FND, thus implying a psychological etiology of these disorders. Congruently with this view, psychotherapy associated with pharmacological therapy is considered the most appropriate treatment by psychiatrists, while physiotherapy is an under-recognized treatment option for FND. DiscussionThe present study highlights that a psychogenetic view of FND dominates among Italian psychiatrists. This could be due to out-of-date knowledge about the pathophysiology of this group of disorders. Promoting education about novel approaches to FND would be of crucial importance to improving care for patients suffering from this condition.

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