Evidence map›Paper›PMID 38860228›Full record

ArticleBMJ neurology open2024

Illness perceptions, experiences of stigma and engagement in functional neurological disorder (FND): exploring the role of multidisciplinary group education sessions.

Cate Bailey, Niruj Agrawal, Sarah Cope, Barnaby Proctor, Bridget Mildon, Matt Butler, Kate Holt, Mark Edwards, Norman Poole, Timothy R Nicholson

Abstract read
In one paragraph

Article in BMJ neurology open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Cate BaileyNeuropsychiatry Research and Education Group, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0003-2719-8558
Niruj AgrawalNeuropsychiatry Service, South West London and St George's Mental Health NHS Trust, London, UK.
Sarah CopeNeuropsychiatry Service, South West London and St George's Mental Health NHS Trust, London, UK.
Barnaby ProctorNeuropsychiatry Service, South West London and St George's Mental Health NHS Trust, London, UK.
Bridget MildonFND Hope International, Salmon, Idaho, USA.
Matt ButlerNeuropsychiatry Research and Education Group, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK.
Kate HoltAtkinson Morley Regional Neurosciences Centre, St George's University Hospitals NHS Foundation Trust, London, UK.
Mark EdwardsNeuropsychiatry Research and Education Group, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK.
Norman PooleNeuropsychiatry Research and Education Group, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK.
Timothy R NicholsonNeuropsychiatry Research and Education Group, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: A critical first step in managing functional neurological disorder (FND) is a positive diagnosis and clear explanation using an understandable illness model. Multidisciplinary group education sessions are one way to achieve this, with some evidence they improve understanding, confidence in diagnosis and outcomes with further treatment. In many conditions, illness perceptions and stigma affect distress, functioning, quality of life and engagement. Exploring relationships between these factors could lead to deeper understanding of the impact of education. Methods: Questionnaires assessing illness perceptions, quality of life, mood, anxiety, comorbidities, treatment engagement and stigma (both experienced and anticipated) were completed before, immediately and 1 month after a multidisciplinary online group education session for FND at a regional neurosciences centre. Free-text data on causal attributions and needs were also collected. Results: 166 patients attended online education sessions from January 2022 to July 2023; 61 (37%) completed presession surveys, 42 (25%) completed postsession and 35 (21%) completed 1 month postsession surveys. Patients reported multiple comorbidities, poor quality of life, functioning and high levels of stigma. Illness perception scores indicated FND as threatening, mysterious and unpredictable, with low personal or treatment control over symptoms. Illness coherence/understanding (mean difference 2.27, p<0.01, 95% CI 1.22 to 4.23) and engagement (mean difference 2.42, p<0.01, 95% CI 0.46 to 4.36) increased after the session. There were no significant changes in stigma, distress, sense of control or anticipated discrimination. Free-text analysis revealed stress and trauma as the most common causal attributions, followed by physical illnesses. Patients requested personalised formulations, practical disability advice, help with explaining the condition to others (eg, employers), peer support and treatment. Conclusion: Multidisciplinary group FND education sessions potentially improve patient understanding and engagement. Clinicians should consider the possible benefits of personalised formulations and linking to practical and peer support. Further work assessing illness perceptions is needed, such as adapting measures for FND.

Indexed as

clinical neurologyfunctional neurological disorder

Identifiers

PMID38860228
PMCPMC11163674

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.