The prognosis of functional (psychogenic) motor symptoms: a systematic review
Abstract
Background The prognosis of functional (or psychogenic) motor symptoms (weakness and movement disorder) has not been systematically reviewed. Methods We systematically reviewed PubMed for all studies of eight or more patients with functional motor symptoms reporting follow-up data longer than 6 months (excluding studies reporting specific treatments). We recorded symptom duration, physical and psychiatric comorbidity, disability, occupational functioning at follow-up and prognostic factors. Results 24 studies were included. There was heterogeneity regarding study size (number of patients (n)=10 491), follow-up duration clinical setting and data availability. Most studies (n=15) were retrospective. Reported symptom outcome was highly variable. Mean weighted follow-up duration was 7.4 years (in 13 studies where data was extractable). The mean percentage of patients same or worse at follow-up for all studies was 39%, range 10% to 90%, n=1134. Levels of physical disability and psychological comorbidity at follow-up were high. Short duration of symptoms, early diagnosis and high satisfaction with care predicted positive outcome in two studies. Gender had no effect. Delayed diagnosis and personality disorder were negatively correlated with outcome. Prognostic factors that varied between studies included age, comorbid anxiety and depression, IQ, educational status, marital status and pending litigation. Conclusions Existing follow-up studies of functional motor symptoms give us some…
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Misdiagnosis of MS or FND causes harm to patients, most generally in the form of a delay to diagnosis and initiation of proper treatment.
“Misdiagnosis of MS or FND causes harm to patients, most generally in the form of a delay to diagnosis and initiation of proper treatment.”
From Functional neurological disorder and multiple sclerosis: a systematic review of misdiagnosis and clinical overlap (2022) · cites this paper as [2]
Patients with FND who are misdiagnosed with MS have a prognosis similar to MS.
“Patients with FND who are misdiagnosed with MS have a prognosis similar to MS [2] but which may improve with more modern evidence-based treatment [3].”
From Functional neurological disorder and multiple sclerosis: a systematic review of misdiagnosis and clinical overlap (2022) · cites this paper as [2]
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- Authors
- Gelauff, J., Stone, J., Edwards, M., & Carson, A.
- Affiliations
- University of Edinburgh (GB)
- UCL Queen Square Institute of Neurology (GB)
- Corresponding author
- Stone, J.
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2013-09-12
- Volume
- 85
- Issue
- 2
- Pages
- 220-226
- ISSN
- 0022-3050 (ISSN-L)
- OpenAlex
- W2115088030
- Cited by
- 368
- References
- 3
- Citations by year
- 2026: 26 · 2025: 33 · 2024: 36 · 2023: 33 · 2022: 45 · 2021: 41 · 2020: 34 · 2019: 35 · 2018: 15 · 2017: 21 · 2016: 21 · 2015: 12 · 2014: 14 · 2013: 2
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- psychogenic movement disorders, prognosis, prognostic factors, symptom duration, physical disability, psychiatric comorbidity, anxiety, depression, personality disorders, early diagnosis, occupational functioning, natural history (disease)
- MeSH terms
- Mental Disorders, Conversion Disorder, Disability Evaluation, Employment, Humans, Prognosis, Risk Factors, Comorbidity, Symptom Assessment
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