An Integrated Approach to Treating Functional Neurological Disorder (Conversion Disorder)

An Integrated Approach to Treating Functional Neurological Disorder (Conversion Disorder)

American Journal of Psychiatry, 2018

Functional Neurological Disorder (FND), previously known as conversion disorder, involves neurological symptoms like altered motor or sensory function that do not match any recognized medical conditions. Doctors diagnose FND by looking for signs that the body’s systems are working fine even though symptoms are present. Unlike somatic symptom disorder, FND symptoms are purely neurological, causing significant disability, with many patients not improving after several months without help. It’s important to note that people with FND are not faking their symptoms.

Cognitive-Behavioral Therapy (CBT) is a key treatment for FND. It educates patients about their condition, stress management, and changes in behavior and thought patterns. CBT helps reduce symptoms and improve quality of life, especially in conditions like psychogenic nonepileptic seizures. CBT can be administered through workbooks, self-guided materials, and therapy sessions, all proven effective in studies. 

Unified agreement on diagnosis and treatment plans among healthcare providers, including neurologists, psychiatrists, mental health clinicians, and physical therapists is essential for effective patient care. Regular communication ensures clarity and consistency in treatment, minimizing unneeded treatments. Physical therapy is beneficial for motor symptoms, while psychiatric care addresses underlying issues like trauma and stress. An integrated approach involving multiple healthcare providers is essential for treating FND effectively, ensuring that patients receive comprehensive care tailored to their specific needs.

Highlights from the Study

“According to DSM-5 (Diagnostic and Statistical Manual of Mental disorders, 5th ed), FND is diagnosed through clinical evidence of preserved physiological function despite these symptoms.”

“Functional MRI studies have shown that patients with functional neurological disorders activate their brain differently than do healthy subjects simulating a similar condition.” 

“In ambulatory neurology clinics, approximately one-third of new patients have medically unexplained symptoms, the second most common diagnostic category after headache.”

“Randomized pilot studies have shown efficacy for CBT in the treatment of psychogenic nonepileptic seizures.”

At Feeling Good Institute, our therapists are trained in evidence-based CBT to help treat Functional Neurological Disorder (FND) and coexisting psychiatric conditions, including depressive disorders, anxiety disorders, and PTSD. We value creating strong, authentic therapeutic relationships and fostering collaboration among neurologists, psychiatrists, physical therapists, and other providers to facilitate comprehensive, personalized care.

Research Brief Author: Cody Sweeney, MA, LPC

Citation: 

O'Neal, M. A., & Baslet, G. (2018). Treatment for patients with a functional neurological disorder (conversion disorder): An integrated approach. American Journal of Psychiatry. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2017.17040450