Favourable outcome without psychotherapy in patients with functional neurologic disorder

To investigate whether patients with functional neurologic disorder (FND) may improve without psychotherapy as was suggested by a retrospective study.

We prospectively studied patients with newly diagnosed FND. At baseline and at 12 months participants filled out a set of self-reported health questionnaires. During the one-year follow up we recorded the use of psychotherapy.

The study group consisted of 193 included participants. After 12 months 60 participants (60/193 = 31.1%) perceived a favourable outcome. Sixty participants (60/191 = 31.4%) were referred for psychotherapy. Multivariable logistic regression showed that participants with a high level of somatisation were less likely to have a favourable outcome (adjusted OR = 0.55; 95% CI: 0.29 to 1.04; p = 0.07). We could not demonstrate an independent significant impact of the use of psychotherapy on favourable outcome (adjusted OR = 0.65; 95% CI: 0.33 to 1.30; p = 0.22).

Our study confirms the results of the retrospective study. The association between a high level of somatisation and a less favourable outcome suggests that neurologists should pay more attention to symptoms other than the neurological, but this does not necessarily mean referral for a psychological intervention.