Outcomes of an Integrated Multidisciplinary Clinic for People with Functional Neurological Disorder.

Background: Functional neurological disorder (FND) is a disabling condition which has poor prognosis without treatment. This study aimed to evaluate the effectiveness of an outpatient integrated multidisciplinary intervention for the condition. Objectives: This study aimed to assess the outcomes of a pilot integrated multidisciplinary treatment clinic for FND with motor symptoms. Methods: Patients were seen simultaneously by a neurology doctor, a physiotherapist, a clinical psychologist, and sometimes a psychiatrist. The primary endpoint was change in quality of life measured by Short Form-36 (SF-36). Secondary outcomes were change in work and social participation measured by the Work and Social Adjustment Scale (WSAS), ability to participate in full-time or part-time employment, self-rated understanding of FND, and self-rated agreement with the diagnosis of FND. Over the year, 13 patients were recruited to the clinic, and 11 agreed to participate in the outcome study. Results: Statistically significant improvements in quality of life were seen across seven out of eight domains of the SF-36, with improvements in individual domains of between 23 and 39 points (of a possible 100). Mean Work and Social Adjustment Scale score halved from 26 to 13 (worst possible is 40). Of the 12 patients treated, one began to work again after complete unemployment, and two who had been working reduced hours due to disability resumed full time work. No patients had worsened occupational status. Conclusions: This intervention is associated with substantial improvements in quality of life and function, and may be more amenable to delivery at non-specialist centers than other described interventions for FND.