Psychologic treatment of functional neurologic disorders

The management of patients with functional neurologic disorders poses many challenges. Psychologic treatments may well start at the point of delivery of the diagnosis, when careful explanations about the nature of the disorder have to be given to the patient and possibly also relatives/carers. Different conceptual models may assist in explaining the factors underlying the presentation, two of which (functional and dissociative) are briefly outlined here. The challenges for neurologists and psychiatrists of delivering a psychologic formulation as part of the diagnosis delivery are considered, along with the importance of clear communication between professionals involved in the patient's care. Existing literature on treatments incorporating psychologic components suggests that, despite limitations in the study designs and the potential bias in some outcome evaluations, there is evidence to support the use of psychologic interventions for at least some functional neurologic disorders, although larger and better-designed studies are required in this area.