Opinion, knowledge, and clinical experience with functional neurological disorders among Italian neurologists: results from an online survey

• Published in: Journal of neurology Vol. 269; no. 5; pp. 2549 - 2559
• Main Authors: Tinazzi, Michele, Fiorio, Mirta, Berardelli, Alfredo, Bonetti, Bruno, Bonifati, Domenico Marco, Burlina, Alessandro, Cagnin, Annachiara, Calabria, Francesca, Corbetta, Maurizio, Cortelli, Pietro, Giometto, Bruno, Guidoni, Silvia Vittoria, Lopiano, Leonardo, Mancardi, Gianluigi, Marchioretto, Fabio, Pellegrini, Maria, Teatini, Francesco, Tedeschi, Gioacchino, Tesolin, Lucia, Turinese, Emanuele, Zappia, Mario, Marotta, Angela
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2022; Springer Nature B.V
• Subjects: Conversion Disorder - diagnosis; Conversion Disorder - therapy; Humans; Medicine; Medicine & Public Health; Mental disorders; Nervous system; Nervous System Diseases - diagnosis; Neurological diseases; Neurological disorders; Neurologists; Neurology; Neuroradiology; Neurosciences; Original Communication; Patients; Psychological aspects; Surveys and Questionnaires; Neurological practice; Survey; Functional neurological disorders; Education; Conversion disorders
• DOI: 10.1007/s00415-021-10840-y
• ISSN: 0340-5354

Background Functional neurological disorders (FND) are disabling medical conditions commonly seen in neurological practice. Neurologists play an essential role in managing FND, from establishing a diagnosis to coordination of multidisciplinary team-based treatment for patients. With this study, we investigated the knowledge and the clinical experience of Italian neurologists in managing patients with FND. Methods Members of the Italian Society of Neurology were invited via e-mail to participate in this ad hoc online survey; 492 questionnaires were returned completed. Results The term “Functional neurological disorders” in reference to FND was used more frequently than other psychological (e.g., psychogenic or conversion), or descriptive terms (e.g., non-organic or stress-related). When speaking with patients, the respondents stated that they preferred explaining symptoms based on abnormal functioning of the nervous system than discussing mental illness and that they would refer their patient to a psychologist rather than to a psychiatrist. Few considered that physiotherapy and psychiatric interventions are useful approaches to treating FND. Some believed that patients simulate their symptoms. Conclusions Overall, the responses suggest that knowledge about scientific advances in FND is somewhat sparse. A psychiatric-centered view of FND opens the way to an approach in which neurobiological and psychological aspects constitute essential factors of the condition. In this context, professional education could improve understanding of FND and optimize patient management.