Highlights
- •Many co-morbidities arise after FND diagnosis.
- •High levels of pain, fatigue and sleep problems before FND diagnosis.
- •Fibromyalgia and CFS/ME were the commonest co-morbidities in this population.
- •High rate of dissatisfaction with care provision.
Abstract
Functional Neurological Disorder (FND) is common and is often accompanied by multiple
comorbid symptoms and conditions. There have been no large-scale studies exploring
the change of its clinical manifestations and comorbidities.
We used an online survey to assess FND patient characteristics, changes to fatigue,
sleep and pain and comorbid symptoms and diagnoses, as well as treatment strategies.
The survey was shared via the charities FND Action and FND Hope.
527 participants were included in the analysis. Most (97.3%) reported experiencing
more than one core FND symptom. Many respondents reported associated pain (78.1%),
fatigue (78.0%) and sleep disturbances (46.7%) before FND diagnosis which often increased
thereafter. Rates of obesity were higher (36.9%) than in the general population. Obesity
was associated with increased pain, fatigue and sleep difficulties. There was frequent
weight gain after diagnosis. 50.0% of participants reported having other diagnoses
prior to FND, while in 43.3% new comorbidities arise after FND diagnosis. Many respondents
reported being dissatisfied with their care, expressing a wish for further follow-up
from mental health (32.7%) and/or neurological services (44.3%).
This large online survey further supports the phenotypic complexity of FND. High rates
of pain, fatigue and sleep disturbance exist before diagnosis but monitoring for change
is worthwhile. Our study identified major gaps in service provision; we highlight
the importance of an open mind regarding change in symptoms; this could aid the early
identification and management of co-morbidities, including obesity and migraine, which
possibly have a negative impact on FND.
Keywords
Abbreviations:
FND (Functional Neurological Disorder)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
February 21,
2023
Received:
November 1,
2022
Identification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
