[Psychiatric Perspectives on Functional Neurological Disorder (Functional Neurological Symptom Disorder)]

Functional neurological disorders (FND), also termed functional neurological symptom disorders in the DSM-5-TR, are characterized by motor or sensory abnormalities lacking neurological explanation. Historically, this condition has been linked to hysteria. The concept of conversion-a psychological mechanism wherein repressed unconscious conflicts manifest as physical symptoms-remains widely accepted, though its validity has yet to be proven. Consequently, diagnosing FND no longer requires identifying psychological factors. Instead, the diagnosis is established based on positive neurological signs that lack an organic explanation. While the understanding of FND is evolving toward a biopsychosocial model, no standardized biological treatment currently exists, highlighting the necessity for psychosocial assessment and intervention. A comprehensive, individualized assessment of the patient's pathological narrative is preferred, in which traditional interpretations of conversion remain relevant. Cognitive behavioral therapy and psychodynamic therapy have been shown to be effective, yet accessibility remains limited, and patients with FND often exhibit reduced engagement. Even in clinical settings with restricted access to structured psychotherapy, the principles of Pierre Janet and Morita therapy can be effectively applied in treatment. Psychiatry is increasingly acknowledged as pivotal in refining treatment methodologies in clinical practice, with careful attention to the complexities of the mind.