Clinical presentation and neuropsychological profiles of Functional Cognitive Disorder patients with and without co-morbid depression
Open accessAbstract
INTRODUCTION: Functional Cognitive Disorder (FCD) is poorly understood. We sought to better characterise FCD in order to inform future diagnostic criteria and evidence based treatments. Additionally, we compared FCD patients with and without co-morbid depression, including their neuropsychological profiles, to determine whether these two disorders are distinct. METHODS: 47 FCD patients (55% female, mean age: 52 years) attending a tertiary neuropsychiatric clinic over a one year period were included. We evaluated sociodemographic characteristics and clinical features including presentation, medications, the presence and nature of co-morbid psychiatric or physical illnesses, and the results of neuropsychometric testing. RESULTS: 23/47 (49%) patients had co-morbid depression. Six had cognitive difficulties greater than expected from their co-morbid conditions suggesting "functional overlay". 34 patients had formal neuropsychological testing; 12 demonstrated less than full subjective effort. 16/22 (73%) of the remaining patients had non-specific cognitive impairment in at least one domain. There were no significant differences between those with and without co-morbid depression. CONCLUSIONS: Our study informs future diagnostic criteria. For example, they should not exclude patients with co-morbid psychiatric illness or abnormal neuropsychometric testing and clinicians should remain open to the possibility of "functional overlay". Furthermore, FCD and depression are distinct disorders that can exist co-morbidly.
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Comorbidity between functional conditions and psychiatric disorder is high and the relationship requires careful elucidation in future studies.
“Nevertheless, comorbidity between functional conditions and psychiatric disorder is high and the relationship requires careful elucidation in future studies (10).”
From A qualitative analysis of patients' day-to-day living with functional cognitive disorder (FCD). (2025) · cites this paper as [10]
The Abstract reports co-morbid depression in 23 of 47 FCD patients, and the Introduction describes a lack of consensus about how FCD and depression relate. But the claim generalizes to functional conditions and psychiatric disorders broadly. The Limitations section cautions that this tertiary-referral cohort may have greater psychiatric co-morbidity than FCD patients in other settings. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThere is still no consensus on how to best manage patients with FCD.
“There is still no consensus on how to best manage this patient group (10).”
From A qualitative analysis of patients' day-to-day living with functional cognitive disorder (FCD). (2025) · cites this paper as [10]
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- Authors
- Bhome, R., Huntley, J. D., Price, G., & Howard, R. J.
- Affiliations
- University College London (GB)
- National Hospital for Neurology and Neurosurgery (GB)
- Corresponding author
- Bhome, Rohan
- Venue
- Cognitive Neuropsychiatry
- Publisher
- Informa UK Limited
- Published
- 2019-03-04
- Volume
- 24
- Issue
- 2
- Pages
- 152-164
- ISSN
- 1354-6805 (ISSN-L)
- 1464-0619
- OpenAlex
- W2921232646
- Cited by
- 45
- References
- 29
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 5 · 2023: 7 · 2022: 6 · 2021: 2 · 2020: 2 · 2019: 3
- FWCI
- 2.58
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Locations
- Cognitive Neuropsychiatry (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health Research
- NIHR UCLH BRC
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- functional cognitive disorder, neuropsychological profile, diagnostic criteria, subjective effort, clinical features, psychiatric comorbidity
- MeSH terms
- Adult, Cognition Disorders, Depression, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Retrospective Studies, Comorbidity
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