TY - JOUR
T1 - Aetiological factors and symptom triggers in functional motor symptoms and functional seizures: a pilot investigation
AU - Millman, L S Merritt
AU - Short, Eleanor
AU - Ward, Emily
AU - Stanton, Biba
AU - Bradley-Westguard, Abigail
AU - Goldstein, Laura
AU - Winston, Joel
AU - Mehta, Mitul
AU - Nicholson, Timothy
AU - Reinders, Antje A. T. S.
AU - David, Anthony S.
AU - Edwards, Mark
AU - Chalder, Trudie
AU - Hotopf, Matthew
AU - Pick, Susannah
PY - 2023/10/19
Y1 - 2023/10/19
N2 - Objective: In this pilot investigation, we aimed to examine aetiological factors and symptom triggers in a sample with functional motor symptoms (FMS) and/or functional seizures (FS). We also sought to assess potential relationships with relevant clinical features (i.e., functional symptoms, quality-of-life, general functioning). Methods: Seventeen participants with FMS/FS and 17 healthy controls (HCs) underwent an in-depth clinical interview and completed questionnaires assessing adverse life events, psychological and physical symptoms, alexithymia, autistic traits, illness perceptions, health-related quality-of-life (HRQoL), and work/social functioning. Results: Participants with FMS/FS perceived varied causes of the disorder including physical (65%), emotional (53%), environmental (47%) and work-related factors (29%). FMS/FS triggers included physical activity/exertion (59%), stress/emotion (59%), sensory experiences (47%) and fatigue (41%). The FMS/FS group reported more adverse events during adolescence (p=.003), alexithymia (p=.001), somatoform dissociation (p<.001), aspects of psychological dissociation (disengagement [p=.003], depersonalisation [p<.001], derealisation [p=.005]), anxiety (p<.001), depression (p<.001), and physical symptoms (p<.001). Participants with FMS/FS had worse HRQoL than HCs (all p-values=.01-<.001) and impaired work/social functioning (p<.001). There were negative associations between HRQoL scores and somatoform dissociation, anxiety and adverse life events (p-values=.034-.005). Conclusion: This sample with FMS/FS reported diverse biopsychosocial aetiological factors and symptom triggers. Current psychological symptoms and lifetime adverse experiences were associated with worse HRQoL. Our future work will examine these factors in larger samples with FMS or FS to better understand their shared and distinct aetiological underpinnings.
AB - Objective: In this pilot investigation, we aimed to examine aetiological factors and symptom triggers in a sample with functional motor symptoms (FMS) and/or functional seizures (FS). We also sought to assess potential relationships with relevant clinical features (i.e., functional symptoms, quality-of-life, general functioning). Methods: Seventeen participants with FMS/FS and 17 healthy controls (HCs) underwent an in-depth clinical interview and completed questionnaires assessing adverse life events, psychological and physical symptoms, alexithymia, autistic traits, illness perceptions, health-related quality-of-life (HRQoL), and work/social functioning. Results: Participants with FMS/FS perceived varied causes of the disorder including physical (65%), emotional (53%), environmental (47%) and work-related factors (29%). FMS/FS triggers included physical activity/exertion (59%), stress/emotion (59%), sensory experiences (47%) and fatigue (41%). The FMS/FS group reported more adverse events during adolescence (p=.003), alexithymia (p=.001), somatoform dissociation (p<.001), aspects of psychological dissociation (disengagement [p=.003], depersonalisation [p<.001], derealisation [p=.005]), anxiety (p<.001), depression (p<.001), and physical symptoms (p<.001). Participants with FMS/FS had worse HRQoL than HCs (all p-values=.01-<.001) and impaired work/social functioning (p<.001). There were negative associations between HRQoL scores and somatoform dissociation, anxiety and adverse life events (p-values=.034-.005). Conclusion: This sample with FMS/FS reported diverse biopsychosocial aetiological factors and symptom triggers. Current psychological symptoms and lifetime adverse experiences were associated with worse HRQoL. Our future work will examine these factors in larger samples with FMS or FS to better understand their shared and distinct aetiological underpinnings.
KW - functional neurological disorder
KW - functional seizures
KW - Psychogenic non-epileptic seizures
KW - dissociative seizures
KW - functional motor disorder
KW - Functional movement disorder
KW - dissociation
KW - aetiology
KW - dissociative disorders
M3 - Article
SN - 0895-0172
JO - Journal of Neuropsychiatry and Clinical Neurosciences
JF - Journal of Neuropsychiatry and Clinical Neurosciences
ER -