Functional Neurological Symptom Disorder in Youth

Area of Science:

• Neurology
• Psychiatry
• Pediatrics

Background:

• Functional neurological symptom disorder (FNSD), previously conversion disorder, presents with motor/sensory impairments incongruent with neurological diseases.
• Somatic symptoms in FNSD, often emerging in adolescence, pose assessment and treatment challenges.
• Recent diagnostic reconceptualization shifts focus to positive neurological findings, removing the stressor requirement.

Purpose of the Study:

• To outline the reconceptualization of FNSD diagnosis and treatment.
• To emphasize a collaborative approach in managing FNSD.
• To highlight the role of pediatricians in FNSD management.

Main Methods:

• Review of diagnostic criteria and treatment paradigms for FNSD.
• Discussion of a collaborative, family-centered approach to care.
• Emphasis on multidisciplinary team involvement, including behavioral specialists.

Main Results:

• The reconceptualization broadens diagnostic scope and shifts treatment focus from mandatory psychotherapy to collaboration.
• A unified treatment approach involving multiple specialties, with pediatricians often central, is recommended for severe cases.
• Validation of patient distress and shared goal-setting facilitate treatment engagement.

Conclusions:

• FNSD management requires a shift towards collaborative care, open communication, and alignment with family perspectives.
• Pediatricians can play a pivotal role in managing youth with FNSD and their families.
• Effective treatment involves validating distress, providing resources, and fostering rapid return to self-efficacy.