TY - JOUR
T1 - Outpatient cbt for motor functional neurological disorder and other neuropsychiatric conditions
T2 - A retrospective case comparison
AU - O’connell, Nicola
AU - Watson, Gillian
AU - Grey, Clare
AU - Pastena, Rosa
AU - McKeown, Kenneth
AU - David, Anthony S.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Objective: No gold-standard treatment exists for motor functional neurological disorder (mFND), and limited evidence has been found for the effectiveness of cognitive-behavioral therapy (CBT) in treating the disorder. This study examined sociodemographic and clinical characteristics, treatment outcomes, and treatment dropout among patients with and without mFND who received CBT in a neuropsychiatric outpatient clinic in the United Kingdom. Methods: Data from a large anonymized psychiatric register were used to identify patients who received outpatient CBT in a neuropsychiatry clinic between 2006 and 2016 and who had either mFND (N=98) or other neuropsychiatric conditions (ONP) (N=76, control group). The study examined sociodemographic characteristics, physical symptom improvement, and changes in clinical outcome and scores on three instruments measuring psychological distress, psychiatric sequelae of brain injury, and depression. Results: The most common mFND symptoms were weakness, pain, and tremors. A logistic regression analysis found no sociodemographic differences between patients with mFND who dropped out early and those who completed CBT. Pre-and post-CBT scores on the three instruments were available for only a small subset of patients; both mFND and ONP patients showed significant improvements in overall scores. A logistic regression analysis found only a single predictor of symptom improvement in the mFND group: acceptance of a psychological explanation of symptoms prior to treatment. Conclusions: Improvements in physical and psychological functioning were similar for patients with mFND and patients with ONP who were treated in a specialist CBT clinic. This study provides evidence that CBT is feasible and effective for some patients with mFND.
AB - Objective: No gold-standard treatment exists for motor functional neurological disorder (mFND), and limited evidence has been found for the effectiveness of cognitive-behavioral therapy (CBT) in treating the disorder. This study examined sociodemographic and clinical characteristics, treatment outcomes, and treatment dropout among patients with and without mFND who received CBT in a neuropsychiatric outpatient clinic in the United Kingdom. Methods: Data from a large anonymized psychiatric register were used to identify patients who received outpatient CBT in a neuropsychiatry clinic between 2006 and 2016 and who had either mFND (N=98) or other neuropsychiatric conditions (ONP) (N=76, control group). The study examined sociodemographic characteristics, physical symptom improvement, and changes in clinical outcome and scores on three instruments measuring psychological distress, psychiatric sequelae of brain injury, and depression. Results: The most common mFND symptoms were weakness, pain, and tremors. A logistic regression analysis found no sociodemographic differences between patients with mFND who dropped out early and those who completed CBT. Pre-and post-CBT scores on the three instruments were available for only a small subset of patients; both mFND and ONP patients showed significant improvements in overall scores. A logistic regression analysis found only a single predictor of symptom improvement in the mFND group: acceptance of a psychological explanation of symptoms prior to treatment. Conclusions: Improvements in physical and psychological functioning were similar for patients with mFND and patients with ONP who were treated in a specialist CBT clinic. This study provides evidence that CBT is feasible and effective for some patients with mFND.
UR - http://www.scopus.com/inward/record.url?scp=85078550619&partnerID=8YFLogxK
U2 - 10.1176/appi.neuropsych.19030067
DO - 10.1176/appi.neuropsych.19030067
M3 - Article
C2 - 31466518
AN - SCOPUS:85078550619
SN - 0895-0172
VL - 32
SP - 58
EP - 66
JO - Journal of Neuropsychiatry and Clinical Neurosciences
JF - Journal of Neuropsychiatry and Clinical Neurosciences
IS - 1
ER -