Functional cognitive disorders: clinical presentations and treatment approaches
Open accessAbstract
Functional cognitive disorders (FCDs) are a common cause of subjective and mild cognitive impairment. Isolated FCDs commonly present to the cognitive clinic, but examination of the nature of the symptoms suggests that they can also be understood as a transdiagnostic feature of many other conditions. This article examines methods of formulating the cognitive difficulties in order to identify treatment targets in people with FCDs.
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Despite some recent exceptions, FCD lags behind in this regard and too many clinicians in memory clinics are wary of the diagnosis and its plethora of confusing synonyms, which can hinder research.
“However, despite some recent exceptions (6, 33, 37) FCD lags behind in this regard and too many clinicians in memory clinics are wary of the diagnosis and its plethora of confusing synonyms (8), which can hinder research (4).”
From A qualitative analysis of patients' day-to-day living with functional cognitive disorder (FCD). (2025) · cites this paper as [37]
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Functional cognitive disorders: a systematic review
McWhirter, L., Ritchie, C., Stone, J., & Carson, A. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30405-5 · Cited by 240 · see citing works
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Self-citationFunctional cognitive disorder: dementia’s blind spot
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Memory Perfectionism is Associated with Persistent Memory Complaints after Concussion
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The frequency and framing of cognitive lapses in healthy adults
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Self-citationMetacognitive Performance on Memory and Visuospatial Tasks in Functional Cognitive Disorder
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“Given that FCD is a likely common cause for cognitive symptoms, continuous work is required to improve screening and diagnostic workflow [18].”
Self-citationRioux, M., Mamman, R., Byworth, M., Panenka, W. J., Howard, A. K., Perez, D. L., Schmidt, J., Courchesne, C., LeMoult, J., Heran, M. K. S., et al. (2024) · BMJ Neurology Open · doi:10.1136/bmjno-2024-000666 · Cited by 12 · see citing works
“15 Another likely perpetuating factor for FCD is catastrophising, 14 the tendency to perceive symptoms as concerning, problematic, intolerable or otherwise threatening.”
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“The historical features and pa - tient characteristics found to be discriminative between people with FMDs and non-FMDs are likely to generalize to other functional syndromes based on existing clinical data [ 37, 45 ], and further prospec - tive studies would be useful in this regard.”
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A Case of Functional Cognitive Disorder: Psychotherapy and Speech and Language Therapy Insights
Godena, E. J., Freeburn, J. L., Silverberg, N. D., & Perez, D. L. (2023) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000379 · Cited by 6 · see citing works
Jirásek, M., Sieger, T., Chaloupková, G., Nováková, L., Sojka, P., Edwards, M. J., & Serranová, T. (2025) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2025.112071 · Cited by 4 · see citing works
“While the pacing and graded activity could help improve fatigue [35], further studies are needed to assess whether cognitive rehabilitation and behavioural or pharmacological approaches address cognitive and mood fluctuations in this population [36–38].”
Taking Control of Your Functional Cognitive Symptoms: Workbook —A Novel Intervention
Cotton, E., Mordecai, K. L., McWhirter, L., Cabreira, V., Patten, R. V., Silverberg, N. D., Kaat, A. J., & LaFrance, W. C., Jr. (2025) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.20240231 · Cited by 4 · see citing works
Self-citationA qualitative analysis of patients' day-to-day living with functional cognitive disorder (FCD).
Mantovani, N., Poole, N., Cope, S., Vanzan, S., Duffus, A., Williams, T., Smith, J. G., Barrett, B., Scicluna, M., Beardmore, S., et al. (2025) · Disability and Rehabilitation · doi:10.1080/09638288.2025.2460725 · Cited by 2 · see citing works
“However, despite some recent exceptions [6,34,38] FCD lags behind in this regard and too many clinicians in memory clinics are wary of the diagnosis and its plethora of confusing synonyms [8], which can hinder research [4].”
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“Specifically, the sessions incorporate Cognitive Behavioral Therapy (CBT), which utilizes problem-focused interventions geared towards helping the participant better understand how their thoughts, emotions, and behavior are linked and thus can be modified [44].”
Cognitive dysfunction in functional seizures: a neurologist's perspective
Hoeritzauer, I. (2024) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00177-9 · Cited by 1 · see citing works
García‐Roldán, E., Almodóvar‐Sierra, Á., Luque‐Tirado, A., Cabañas, A. M. M., Sánchez‐Arjona, M. B., & Macías, E. F. (2025) · European Journal of Neurology · doi:10.1111/ene.70383 · Cited by 1 · see citing works
“…consultation-friendly tools are needed to capture the characteristic symptoms and positive signs of FCD. Existing questionnaires [10, 11] have not been validated against biologically defined cohorts and do not fully address the multidimensional nature of FCD described in previous reports [4, 6, 7].”
InfluentialThe active construction of past episodes
Parr, T., Pezzulo, G., & Friston, K. J. (2026) · Translational Neuroscience · doi:10.1515/tnsci-2025-0391 · Cited by 1 · see citing works
“…between the two hierarchical levels that led to a failure to encode, as is often associated with diagnoses of functional cognitive disorders [49]; (2) an attenuation of the precise mapping between levels for the semantic states relevant to explanation, which led to a failure to retrieve…”
Functional Neurological Disorder
Lane, C. E. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-95702-1.00038-5
Functional Neurological Symptom Disorder in Children and Adolescents
Chee, P., Williams, S. E., & Zahka, N. E. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-10944-7.00107-4
Persisting Symptoms After Concussion and Functional Neurological Disorder: Points of Intersection
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Funktionelle kognitive Störungen erkennen und verstehen
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Treatment of Functional Neurological Disorders
Park, J. E. (2026) · Journal of Clinical Neurology · doi:10.3988/jcn.2026.0223
“59 An individualized approach is most appropriate, and patients may benefit from neuropsychological therapies including CBT, compassion-focused therapy, or acceptance and commitment therapy.”
Silverberg, N. D., Burke, M. J., Debert, C. T., Klotz, T., Zemek, R. L., Schmidt, J., Panenka, W. J., Perez, D. L., Bayley, M. T., Tartaglia, M. C., et al. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-125787
“19–22 Modifiable psychological factors likely contribute to functional memory symptoms after concussion (and in other clinical contexts).”
- Authors
- McWhirter, L., & Carson, A.
- Affiliations
- University of Edinburgh (GB)
- Corresponding author
- McWhirter, Laura
- Venue
- Practical Neurology
- Publisher
- BMJ
- Published
- 2022-12-08
- Volume
- 23
- Issue
- 2
- Pages
- 104-110
- ISSN
- 1474-7758 (ISSN-L)
- 1474-7766
- OpenAlex
- W4311888116
- Cited by
- 20
- References
- 11
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 6 · 2023: 3
- FWCI
- 2.60
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- cc-by
- Locations
- Practical Neurology (publishedVersion)
- PubMed (publishedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- 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
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- functional cognitive disorder, subjective cognitive impairment, mild cognitive impairment, transdiagnostic features, cognitive difficulties, treatment goals, clinical features, cognitive assessment
- MeSH terms
- Cognition, Cognition Disorders, Humans, Cognitive Dysfunction
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