Mindfulness-based stress reduction for functional neurological disorder: A feasibility study

Functional neurological disorder (FND) is common and associated with substantial disability, yet evidence-based treatment options remain limited. Because maladaptive attentional processes are central to FND pathophysiology, mindfulness-based interventions may be beneficial. Mindfulness-Based Stress Reduction (MBSR) has strong empirical support across physical and mental health conditions, but evidence in FND is sparse.

To assess feasibility, acceptability, and preliminary clinical outcomes of MBSR for patients with FND.

In this monocentric, single-arm feasibility study, German-speaking adults with confirmed FND were recruited from a specialized outpatient clinic. Participants completed an 8-week standardized MBSR program across three course cycles (two in-person, one online). Primary outcomes included recruitment, retention, attendance, and self-reported home practice; acceptability was assessed via recommendation likelihood. Secondary outcomes included health-related quality of life (WHODAS 2.0), functional impairment (WSAS), depressive (PHQ-9) and anxiety symptoms (GAD-7), and FND symptom burden (FNSQ). Assessments occurred at baseline, post-intervention, and three-month follow-up.

Of 57 eligible patients, 24 enrolled (42%); 22 completed the course (92%). Recommendation likelihood was high. Statistically significant pre-post improvements were observed in WHODAS 2.0 (d = -0.56) and WSAS (d = -0.67), with comparable values at three-month follow-up. Post-intervention PHQ-9 scores improved (d = -0.75), FNSQ symptom count decreased (d = -0.68), whereas GAD-7 changes were nonsignificant. Online delivery demonstrated particularly strong adherence without dropouts.

MBSR for FND is feasible and well-accepted. A randomized controlled trial is warranted to determine efficacy. Future research could serve as a model for transforming patient-centered care in the digital era.

German Clinical Trials Register (DRKS00034806).