New article about the economic cost of FNDs. I tried clicking on the DOI link but it didn't work for me, so you may need to copy and paste.

[210272]

Economic Cost of Functional Neurologic Disorders

A Systematic Review

Brian O'Mahony, Glenn Nielsen, Sallie Baxendale, Mark J. Edwards, Mahinda Yogarajah

First published June 20, 2023, DOI: doi.org/10.1212/WNL.0000000...

N.B. As far as I can tell they are not including the costs for people deemed to be in the subsets of FND and there is controversy about the '16% of neurology clinic referrals'. At least this paper is not behind a paywall, unlike many others about FND.

[Lady4]

I can't access on my phone as it keeps timing out but will try again later. Thanks for sharing.

[Lady4]

Ps. Tried copying and pasting and also accessing main site and searching for article, which I found but couldn't open.

[210272 in reply to Lady4]

I saw it on Facebook (accessed from my laptop) via Neurology Journal and managed to open it from there but it was late and I can't remember how I did it I'll have another go tomorrow and see if I can figure out what might work for you.

[210272]

Lady4 There's a podcast to go with it and I could access the paper from there, too:

Prof. Jon Stone talks with Dr. Mahinda Yogarajah about the importance of diagnosing and not misdiagnosing functional neurologic disorders.

Read the related article in Neurology.

This podcast is sponsored by argenx. Visit vyvgarthcp.com for more information.

DOI: 10.1212/WNL.0000000000207388

I think the description of this podcast is slightly misleading because Jon Stone didn't talk about not misdiagnosing FNDs.

[Misstea]

That link does not work and I am on my laptop

[210272 in reply to Misstea]

Apologies, I didn't realise the link to the podcast didn't work here. As far as I can tell we can only access the podcast via the paper, via Neurology Journal. But there's also a post about it in the Neuroscience News and Research Group on Facebook so if you can't access it (and Jon's podcast) via Neurology Journal you should be able to read about it there.

[MONIREN]

Just a question, do you have FND? You seem to only put links on here.

[210272 in reply to MONIREN]

I do try to respond to some of the posts I read on here too. But since the moderators/admins of this Hub don't seem to post many papers here, I try to do that too, when I can. As for whether I have a FND or not (good question, thank you), that depends on who you talk to. I have (or had, since I'm now in remission) Mal de Debarquement Syndrome (think 'bad disembarkment') and the diagnostic criteria for that infer that it is a 'functional' condition but I'm not convinced that it is.

I am interested in health economics and have been for a long time, hence my interest in this particular paper.

Hope you're doing OK and, if I can ask a question in return, do you think FND should be in DSM?

[Crypto127]

Part of any discussion about the clinical costs of FND patients must include looking at the sensitivity and specificity of Rule-In Positive Features of FND. If a positive diagnosis of FND then prevents further testing, we must have confidence in that gatekeeper diagnosis and the basis on which it is made. Like many things, the goalposts do seem to move - at one point, the ability to continue to be fully aware of your surroundings in a seizure was a positive sign. Latest information from publications with backing from FND experts says lack of recall is a positive sign.

[210272 in reply to Crypto127]

Thank you and I did not know that the positive signs re seizures had changed. I guess the goalposts will continue to move as medical knowledge about many conditions, including FND, changes over time. However the FND Society do 'very bad' patient engagement so patient driven changes (IE those that accrue as a result of the lived-experiences of patients) aren't easily achievable. The investigative journalist, David Tuller, was looking into the reliability of the 'positive signs' for a FND dx and I hope he will do so again.