Measuring Change in Individuals With Functional Neurological Symptom Disorder

Functional Neurological Symptom Disorders (FNSD) are one of the commonest reasons why patients are referred to neurologists. They are as disabling as neurological disorders causing similar symptoms related to more readily demonstrable pathophysiological or structural changes, however, FNSD are more commonly associated with psychiatric comorbidities. Psychotherapy is a treatment option for FNSD although there is still a dearth of reliable evidence that psychotherapy works for FNSD or how it may help. This is partly due to the nature of psychotherapeutic interventions but also to the difficulties associated with studying treatment outcome in a patient population that is highly heterogeneous in terms of aetiology and clinical presentation. This study contributes to a larger research project that is examining the efficacy of specialist psychotherapy for patients with FNSD utilising a range of approaches including objective cognitive and behavioural measures and subsequently exploring the reliability and usefulness of different outcome measurement approaches in this patient group. This study specifically aims to assess whether psychotherapy treatment in FNSD infers any change in cognitive behaviours of impulsivity and biases in the processing of emotional information. FNSD patients will complete two computer-based tasks and health-related questionnaires before, immediately after and at 6-months follow up after completing psychotherapy treatment sessions to measure any treatment-associated improvements. Data collected from patients not receiving any psychotherapy and participants without FNSD will provide longitudinal and cross-sectional control data respectively.